Gómez-Martínez Ricardo, Rosales-Gradilla María Elena, Silva-Padilla Noemí, Corona-Macías Adrián
Department of Oncology, UMAE Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
J Pediatr Ophthalmol Strabismus. 2013 May-Jun;50(3):174-7. doi: 10.3928/01913913-20130306-02. Epub 2013 Mar 13.
To describe the relationship between retinoblastoma differentiation, histopathological risk factors, age at enucleation, laterality, and genetic type (hereditary or sporadic) in a series of enucleated eyes in a referral hospital. The criteria used in other studies to classify retinoblastoma differentiation are discussed.
The authors retrospectively studied histopathological preparations of eyes with retinoblastoma treated with primary enucleation. Tumors were classified as well differentiated, undifferentiated, and moderately differentiated. Patient age at enucleation, laterality of disease, genetic form (hereditary or sporadic), and presence of histopathological risk factors (massive choroidal infiltration, postlaminar optic nerve invasion, tumor in optic nerve cut, scleral invasion, and involvement of orbital soft tissues) were analyzed. The chi-square test was used for categorical variables and analysis of variance for test mean differences.
Histopathological risk factors were present in 23 (36%) of 63 eyes. Moderately differentiated tumors occurred at advanced ages and were more frequently associated with histopathological risk factors.
A consensus is needed to establish the histopathological criteria of retinoblastoma differentiation. The value of rosettes as a marker of cell differentiation should be reviewed.[J Pediatr Ophthalmol Strabismus 2013;50(3):174-177.].
描述在一家转诊医院的一系列摘除眼球病例中，视网膜母细胞瘤的分化、组织病理学危险因素、摘除眼球时的年龄、病变部位以及遗传类型（遗传性或散发性）之间的关系。讨论了其他研究中用于对视网膜母细胞瘤分化进行分类的标准。
作者回顾性研究了接受初次眼球摘除术治疗的视网膜母细胞瘤患者的眼部组织病理学标本。肿瘤被分类为高分化、未分化和中分化。分析了患者摘除眼球时的年龄、病变部位、遗传形式（遗传性或散发性）以及组织病理学危险因素（脉络膜广泛浸润、筛板后视神经侵犯、视神经断端肿瘤、巩膜侵犯以及眼眶软组织受累）的存在情况。卡方检验用于分类变量，方差分析用于检验均值差异。
63只眼中有23只（36%）存在组织病理学危险因素。中分化肿瘤发生于较高年龄，并且更常与组织病理学危险因素相关。
需要就视网膜母细胞瘤分化的组织病理学标准达成共识。应重新审视菊形团作为细胞分化标志物的价值。[《小儿眼科与斜视杂志》2013年；50(3):174 - 177。]
