Ocular Pathology Services, Dr R. P. Centre for Ophthalmic Sciences, All India Institute of Ophthalmic Sciences, Ansari Nagar, New Delhi, India.
Arch Pathol Lab Med. 2012 Feb;136(2):190-3. doi: 10.5858/arpa.2010-0759-OA.
In eyes enucleated for retinoblastoma, presence of histopathologic high-risk factors is associated with a higher risk of local recurrence and systemic metastasis.
To evaluate histopathologic features in children with retinoblastoma in our population and establish relationship between age, tumor differentiation, and high-risk features.
Retrospective histopathologic analysis of 609 consecutively enucleated eyes for advanced intraocular retinoblastoma during a 10-year period. A nonparametric test was used to establish relationship between age, differentiation, and high-risk features.
Poorly differentiated retinoblastoma presented in 80.3% and well-differentiated in 19.7% of eyes. Well-differentiated tumors presented earlier (median 1.2 years) than poorly differentiated tumors (median 2.5 years) (P < .001). One hundred fourteen eyes (18.7%) had 1 and 138 (22.7%) had at least 2 high-risk histopathologic factors. Invasion of anterior chamber was found in 10.0%, iris in 10.7%, ciliary body in 6.7%, sclera in 13.7%, massive choroid in 24.6%, postlaminar optic nerve in 16.1%, resected margin of the optic nerve in 7.4%, and extrascleral tissue in 4.1% of eyes. Extensive necrosis was seen in 31.0% of eyes. Poorly differentiated tumors were significantly associated with presence of more than 1 high-risk histopathologic feature (P < .001) and extensive necrosis (P < .001).
Poorly differentiated tumors present at a later age and are associated with presence of multiple high-risk factors and extensive necrosis. In our population, high-risk histopathologic factors are present in a significant number of eyes. Because we have included only primarily enucleated eyes, this could truly represent the distribution of high-risk histopathologic factors in children with retinoblastoma.
在因视网膜母细胞瘤而被摘除眼球的患者中，存在组织病理学高危因素与局部复发和全身转移的风险增加相关。
评估本地区视网膜母细胞瘤患儿的组织病理学特征，并确定年龄、肿瘤分化程度与高危特征之间的关系。
回顾性分析了 10 年间连续 609 例因眼内晚期视网膜母细胞瘤而被摘除眼球患者的组织病理学资料。采用非参数检验来确定年龄、分化程度和高危特征之间的关系。
低度分化的视网膜母细胞瘤占 80.3%，高度分化的占 19.7%。高度分化的肿瘤发病较早（中位数为 1.2 岁），而低度分化的肿瘤发病较晚（中位数为 2.5 岁）（P<0.001）。114 只眼（18.7%）有 1 个及以上高危组织病理学因素，138 只眼（22.7%）至少有 2 个高危组织病理学因素。前房侵犯的发生率为 10.0%，虹膜侵犯为 10.7%，睫状体侵犯为 6.7%，巩膜侵犯为 13.7%，脉络膜广泛受累为 24.6%，视神经后段受累为 16.1%，视神经切缘受累为 7.4%，眼外组织受累为 4.1%。31.0%的眼可见广泛坏死。高度分化的肿瘤与存在多个高危组织病理学特征（P<0.001）和广泛坏死（P<0.001）显著相关。在本研究中，大量患者存在高危组织病理学特征。由于我们仅纳入了初次行眼球摘除术的患者，因此这些高危组织病理学特征可能真实反映了本地区视网膜母细胞瘤患儿的高危特征分布情况。
