论文部分内容阅读
目的探讨视网膜母细胞瘤（ｒｅｔｉｎｏｂｌａｓｔｏｍａ，Ｒｂ）脉络膜浸润的形态学分期标准，为在统一的标准下进一步对该肿瘤进行临床病理研究。方法对摘除的２９７例原发性Ｒｂ患者的眼球组织标本，进行光镜观察。结果肿瘤侵犯球壁组织在形态学上可分为４期（色素上皮脉络膜分期）：Ⅰ期，仅为视网膜色素上皮层受侵犯，玻璃体膜结构完整。Ⅱ期，玻璃体膜结构被破坏，脉络膜毛细血管层尚未被侵犯。Ⅲ期，肿瘤浸润深达脉络膜，靠近毛细血管层的中血管层内的小范围区域。Ⅳ期，大范围脉络膜浸润，巩膜可同时受累。Ⅳ期病死率为１１５％，Ⅰ～Ⅲ期的病死率为０４％。结论色素上皮脉络膜分期可作为研究不同个体肿瘤细胞浸润程度进行比较的统一标准。
Objective To investigate the morphological staging criteria of retinoblastoma (Rb) choroidal infiltration, and to further investigate the clinical pathology of this tumor under a unified standard. Methods The ocular tissues of 297 patients with primary Rb removed were observed under light microscope. Results The tumor invasion of the spherical wall tissue can be divided into 4 stages (pigmentary epithelial choroid stage): stage I, only the retinal pigment epithelium is invaded, and the vitreous membrane structure is complete. In phase II, the vitreous membrane structure was destroyed and the choroid capillaries had not been violated. In stage III, the tumor infiltrates deep into the choroid, close to the small area within the capillary layer of the middle vascular layer. In stage IV, a large area of choroidal infiltration occurs, and the sclera can be involved at the same time. The stage IV mortality rate was 115%, and the I-III stage mortality rate was 04%. Conclusion Pigment epithelial-choroidal staging can be used as a unified standard to compare the degree of tumor cell infiltration in different individuals.