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埃塞俄比亚视网膜母细胞瘤的临床病理表现

Clinicopathological Presentation of Retinoblastoma in Ethiopia.

作者信息

Sherief Sadik Taju, Mulatu Daniel Getaneh, Wu Fran, O'Banion Jacquelyn, Dimaras Helen

机构信息

aDepartment of Ophthalmology, Addis Ababa University, Addis Ababa, Ethiopia.

bDepartment of Ophthalmology, Menelik II Hospital, Addis Ababa, Ethiopia.

出版信息

Ocul Oncol Pathol. 2022 Nov;8(3):168-174. doi: 10.1159/000525113. Epub 2022 Jul 4.

Abstract

The presenting symptoms of retinoblastoma in Ethiopia, as well as their relationship to the stage of the disease, are poorly understood, but they could be important as background knowledge for creating early detection initiatives. This study aimed to describe the clinical and histopathological characteristics of retinoblastoma among Ethiopian patients. A hospital-based cross-sectional analysis of all children with newly diagnosed retinoblastoma during the study period of May 2015 to December 2019, inclusive, who presented to a tertiary referral center during were included. Demographic, clinical, and histological characteristics were collected and descriptive statistics were done using SPSS Version 20.0 software. A total of 217 patients (unilateral 84.3%, bilateral 15.7%) were studied. The median age at presentation was 29 months (34 months vs. 19.5 months in unilateral and bilateral cases, respectively, < 0.001). Among all patients, 57.8% were male. Leukocoria was the most common presenting sign (37.3%) and followed by fungating mass (31.8%). Tumors were extraocular in 40.1% of cases. From the intraocular cases, 73.3% were advanced International Intraocular Retinoblastoma Classification Group D or E disease. Sixty-two (54.4%) of the eyes had high-risk pathological features. The median lag time was significantly shorter for intraocular versus extraocular cases (5 months vs. 12 months, respectively, < 0.001). Our results show that the majority of Ethiopian children with retinoblastoma have delayed presentation and late stage at diagnosis. This suggests that national health promotion campaigns to increase public knowledge on the presenting signs of retinoblastoma may be critical to achieving early diagnosis. Furthermore, the development of standard management guidelines informed by this study will be helpful in managing the complex and advanced cases currently observed.

摘要

在埃塞俄比亚,视网膜母细胞瘤的呈现症状及其与疾病分期的关系尚不清楚,但作为创建早期检测倡议的背景知识,它们可能很重要。本研究旨在描述埃塞俄比亚患者视网膜母细胞瘤的临床和组织病理学特征。对2015年5月至2019年12月(含)研究期间所有新诊断为视网膜母细胞瘤且前往三级转诊中心就诊的儿童进行了基于医院的横断面分析。收集了人口统计学、临床和组织学特征,并使用SPSS 20.0软件进行描述性统计。共研究了217例患者(单侧84.3%,双侧15.7%)。就诊时的中位年龄为29个月(单侧和双侧病例分别为34个月和19.5个月,<0.001)。所有患者中,57.8%为男性。白瞳症是最常见的就诊体征(37.3%),其次是蕈样肿块(31.8%)。40.1%的病例肿瘤侵犯眼球外。在眼内病例中,73.3%为国际眼内视网膜母细胞瘤分类D组或E组晚期疾病。62只眼(54.4%)具有高危病理特征。眼内病例与眼球外病例的中位延迟时间显著缩短(分别为5个月和12个月,<0.001)。我们的结果表明,大多数埃塞俄比亚视网膜母细胞瘤患儿就诊延迟且诊断时处于晚期。这表明开展全国性的健康促进活动以提高公众对视网膜母细胞瘤就诊体征的认识对于实现早期诊断可能至关重要。此外,根据本研究制定标准管理指南将有助于管理目前观察到的复杂和晚期病例。

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