Rodriguez Aurora, Kelley Caitlin, Patel Anjali, Ramasubramanian Aparna
School of Medicine, Creighton University, Phoenix, AZ, USA.
Ophthalmology Department, Phoenix Children's Hospital, Phoenix, AZ, USA.
Int J Gen Med. 2023 Mar 27;16:1101-1110. doi: 10.2147/IJGM.S380634. eCollection 2023.
The objective of this review is to explore the prenatal diagnosis of retinoblastoma and the recommended screening practices.
An electronic literature search on prenatal diagnosis of retinoblastoma was conducted on the PubMed database. Publications within the last 20 years that matched the inclusion criteria were selected. The literature search included the following keywords: retinoblastoma, prenatal, diagnosis, screening, and associated synonyms to increase search sensitivity. Nine studies were included for investigation and extracted to identify prenatal diagnostic and screening techniques for retinoblastoma, their associated impact, and the target population that should receive prenatal screening for retinoblastoma.
Familial retinoblastoma has an autosomal inheritance pattern and 90% penetrance. Therefore, future parents with a family history of retinoblastoma are strongly advised to get tested for retinoblastoma (Rb) gene mutations; if one of the parents is positive for a mutated allele of the RB1 gene, there is a 45% chance that their child will inherit a mutated allele of the retinoblastoma gene, rendering the allele non-functional in all of the cells of the individual and predisposing the child to a higher risk of developing retinoblastoma as well as other secondary cancers. Thus, prenatal screening and diagnosis of retinoblastoma is crucial for early diagnosis and optimal treatment.
Prenatal testing for retinoblastoma in high-risk families is important for everyone in the family. For the parents, prenatal screening has been shown to improve their family planning decisions and psychological well-being as they can mentally prepare beforehand and make informed decisions. More importantly, these practices have shown to yield better treatment and vision outcomes in the newborn.
本综述的目的是探讨视网膜母细胞瘤的产前诊断及推荐的筛查方法。
在PubMed数据库中对视网膜母细胞瘤的产前诊断进行电子文献检索。选取过去20年内符合纳入标准的出版物。文献检索包括以下关键词:视网膜母细胞瘤、产前、诊断、筛查及相关同义词,以提高检索敏感性。纳入9项研究进行调查和提取,以确定视网膜母细胞瘤的产前诊断和筛查技术、其相关影响以及应接受视网膜母细胞瘤产前筛查的目标人群。
家族性视网膜母细胞瘤具有常染色体遗传模式和90%的外显率。因此,强烈建议有视网膜母细胞瘤家族史的准父母进行视网膜母细胞瘤(Rb)基因突变检测;如果父母一方RB1基因的突变等位基因呈阳性,其孩子有45%的几率继承视网膜母细胞瘤基因的突变等位基因,使该等位基因在个体的所有细胞中失去功能,从而使孩子患视网膜母细胞瘤以及其他继发性癌症的风险更高。因此,视网膜母细胞瘤的产前筛查和诊断对于早期诊断和最佳治疗至关重要。
对高危家庭进行视网膜母细胞瘤的产前检测对家庭中的每个人都很重要。对于父母来说,产前筛查已被证明可以改善他们的计划生育决策和心理健康,因为他们可以提前做好心理准备并做出明智的决定。更重要的是,这些做法已被证明能为新生儿带来更好的治疗效果和视力预后。