不同年龄组视网膜母细胞瘤的组织病理学观察

The Histopathological Observation of Retinoblastoma in Different Age Groups

目的 探讨视网膜母细胞瘤 (retinoblastoma,RB)在不同年龄组中的组织病理特点。方法 对 1985～ 1995年间摘除的 2 97只 RB眼球的病理切片 ,重新在光镜下观察。比较 3个年龄组段 (<18个月 ,18～ 6 0个月 ,>6 0个月 )的肿瘤细胞分化程度及对球壁和视神经的浸润情况。结果 小于 18个月组的肿瘤细胞以分化好为主 (5 9.2 4 % ) ,18～ 6 0个月组以及大于 6 0个月组的肿瘤细胞以分化差为主 (6 9.90 %～ 90 .0 0 % )。肿瘤细胞对球壁和视神经的浸润在小于 18个月组和大于 6 0个月组中表现类似 ,浸润轻而少见 ,而在 18～ 6 0个月组中则表现为浸润程度重而多见。结论 随着患者年龄的增长 ,肿瘤细胞逐渐由分化较好转化为以分化较差为主。5岁以内 RB患者的肿瘤细胞分化程度越差 。

Objective To investigate the histopathological features of retinoblastoma (RB) in different age groups. Methods The differentiation degree of tumor cells and the invasion of wall of eye globe and optic nerve were retrospectively observed on the histopathological sections of 297 cases of primary enucleated eyes with RB from 1985 to 1995 under light microscopy in three age groups. Results In the group with age under 18 months there were mainly well differentiated tumor cells (59 24 %), but in the groups with age between 18-60 months and over 60 months the tumor cells were poorly differentiated (69 90 %-90 %). The invasion of wall of eye globe and optic nerve in the group with age between 18-60 months was serious and was seen more than in the group with age under 18 and over 60 months. Conclusion The older the patient was, the higher the ratio of undifferentiated tumor cells was. The invasion of wall of eye globe and optic nerve was more distinct if the tumor had more undifferentiated cells in the group with age under 5 year old.