高危眼内视网膜母细胞瘤：两个主要转诊中心的亚裔印度人和美国人之间的比较。
HIGH-RISK INTRAOCULAR RETINOBLASTOMA: Comparison Between Asian Indians and Americans From Two Major Referral Centers.
机构信息
Ocular Oncology Service, The Operation Eyesight Universal Institute for Eye Cancer, L. V. Prasad Eye Institute, Hyderabad, India.
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
出版信息
Retina. 2018 Oct;38(10):2023-2029. doi: 10.1097/IAE.0000000000001816.
PURPOSE
To identify the differences in the clinical and histopathologic features in eyes with advanced intraocular retinoblastoma in a developing country (India) versus a developed country (USA).
METHODS
Retrospective study.
RESULTS
Of 524 patients with retinoblastoma who underwent primary enucleation, 331 were from India, and 193 were from the USA. Asian Indians were older at presentation (35 months vs. 29 months; P = 0.02), had thicker tumors (13.8 mm vs. 12.4 mm; P = 0.0001) compared with Americans. High-risk intraocular retinoblastoma was more common in Asian Indians with a 2-fold greater risk compared with Americans (35% vs. 23%; odds ratio = 1.83; P = 0.003). Statistically significant differences in the histopathologic features (Asian Indians vs. Americans) included massive (≥3 mm) choroidal infiltration (17% vs. 6%; P = 0.0003) and optic nerve infiltration (48% vs. 15%; P = 0.0001). Asian Indians had a 5-fold greater risk of having optic nerve invasion (odds ratio = 5.45; P < 0.0001) and 3-fold greater risk of massive choroidal invasion (odds ratio = 2.80; P < 0.0001) compared with Americans. With appropriate use of adjuvant systemic chemotherapy, the difference in the rates of systemic metastasis (5% vs. 2%, P = 0.67) and related death in both countries (5% vs. 0%, P = 0.14) were not statistically significant.
CONCLUSION
High-risk intraocular retinoblastoma is more common in Asian Indians compared with Americans.
目的
比较发展中国家（印度）与发达国家（美国）晚期眼内视网膜母细胞瘤的临床和组织病理学特征差异。
方法
回顾性研究。
结果
在接受初次眼球摘除术的 524 例视网膜母细胞瘤患者中，331 例来自印度，193 例来自美国。与美国人相比，印度裔亚洲人就诊时年龄更大（35 个月 vs. 29 个月；P = 0.02），肿瘤更厚（13.8 毫米 vs. 12.4 毫米；P = 0.0001）。亚洲裔印度人更常见高危眼内视网膜母细胞瘤，其风险是美国人的 2 倍（35% vs. 23%；优势比 = 1.83；P = 0.003）。组织病理学特征（亚洲裔印度人与美国人）方面存在统计学显著差异，包括大量（≥3 毫米）脉络膜浸润（17% vs. 6%；P = 0.0003）和视神经浸润（48% vs. 15%；P = 0.0001）。与美国人相比，亚洲裔印度人视神经侵犯的风险高 5 倍（优势比 = 5.45；P < 0.0001），且大量脉络膜侵犯的风险高 3 倍（优势比 = 2.80；P < 0.0001）。在适当使用辅助全身化疗的情况下，两国的全身转移率（5% vs. 2%，P = 0.67）和相关死亡率（5% vs. 0%，P = 0.14）之间的差异无统计学意义。
结论
与美国人相比，亚洲裔印度人眼内高危视网膜母细胞瘤更为常见。
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