Yousef Yacoub A, Hajja Yasmin, Nawaiseh Ibrahim, Mehyar Mustafa, Sultan Iyad, Deebajah Rasha, Rawashdeh Khalil, Khurma Samer, Jaradat Imad, Al-Hussaini Maysa
Department of Surgery, King Hussein Cancer Center, AMMAN, JORDAN.
Turk Patoloji Derg. 2014;30(3):171-7. doi: 10.5146/tjpath.2014.01260.
To analyze the histopathologic features of the eyes with intraocular retinoblastoma primarily treated by enucleation in a tertiary cancer center in Jordan.
A retrospective case series of 50 eyes for 49 patients who had pathologically confirmed retinoblastoma after enucleation as primary therapy. The main outcome measures included demographics, laterality, international classification of intraocular retinoblastoma, choroid invasion, optic nerve invasion, anterior chamber invasion, and tumor differentiation.
The median age at enucleation was 30 months. Twenty-seven (55%) patients were males, and 19 (39%) patients had bilateral retinoblastoma. High risk pathological features were seen as massive choroid invasion in 9 (18%) eyes, post-laminar optic nerve invasion in 7 (14%) eyes, and anterior chamber, iris or ciliary body invasion in 7 (14%) eyes. Thirty-seven (74%) tumors were well/moderately differentiated, and 13 (26%) were poorly differentiated. Poorly differentiated tumors presented later (median 31 months) than well/ moderately differentiated tumors (26 months) and were associated with a higher incidence of high-risk pathological features. No single ICRB group C eye had high-risk pathological features, while 17% and 4% of group D eyes and 28% and 33% of group E eyes had massive choroid invasion and post-laminar optic nerve invasion, respectively. Eighteen (36%) patients received adjuvant chemotherapy for high risk pathological features, and at median follow up of 40 months, no single case had metastasis or was dead.
Our pathologic findings were similar to the developed world. They were supportive of the predictive power of the international classification of retinoblastoma staging system for the likelihood of high risk pathological features. Poorly differentiated tumors were associated with a higher incidence of high risk pathological features than well/moderately differentiated tumors.
分析在约旦一家三级癌症中心主要通过眼球摘除术治疗的眼内视网膜母细胞瘤的组织病理学特征。
对49例患者的50只眼进行回顾性病例系列研究，这些患者在眼球摘除术后经病理证实患有视网膜母细胞瘤，且眼球摘除术为主要治疗方法。主要观察指标包括人口统计学特征、患侧、眼内视网膜母细胞瘤的国际分类、脉络膜侵犯、视神经侵犯、前房侵犯以及肿瘤分化情况。
眼球摘除术时的中位年龄为30个月。27例（55%）患者为男性，19例（39%）患者患有双侧视网膜母细胞瘤。高风险病理特征表现为9只眼（18%）出现大量脉络膜侵犯，7只眼（14%）出现筛板后视神经侵犯，7只眼（14%）出现前房、虹膜或睫状体侵犯。37只眼（74%）的肿瘤为高分化/中分化，13只眼（26%）为低分化。低分化肿瘤出现时间较晚（中位时间31个月），高于高分化/中分化肿瘤（26个月），且与高风险病理特征的发生率较高相关。国际视网膜母细胞瘤分类（ICRB）中没有C组的眼具有高风险病理特征，而D组眼和E组眼中分别有17%和4%出现大量脉络膜侵犯，28%和33%出现筛板后视神经侵犯。18例（36%）患者因高风险病理特征接受了辅助化疗，中位随访40个月时，没有一例发生转移或死亡。
我们的病理结果与发达国家相似。这些结果支持视网膜母细胞瘤分期系统的国际分类对于高风险病理特征可能性的预测能力。低分化肿瘤比高分化/中分化肿瘤具有更高的高风险病理特征发生率。
