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传统的视网膜母细胞瘤(RB)四期分法尚有不尽妥善处。事实上,本病的发展并非皆循此四期顺序进行,转移可发生在任一阶段:且该分法缺乏统一的分类标准。作者通过大组病例(154例)的临床病理资料分析,和长期随访,70.0％以上青光眼期病例有球外蔓延,而眼内期有球外蔓延的不及10.0％,差别有非常显著意义(P<0.01):随访结果也说明该期病死率明显高于眼内期,有统计学意义(P<0.05)。故认为青光限期病例属眼外期范畴:RB继发高眼压可视为肿瘤球外扩散的临床早期征状。结合文献复习,在四期分法基础上,拟议一个新的RB分期分类,为制定治疗方案及估计预后提供可靠依据(见附表)。本期简明确切,易于掌握,切实可行,适用于我国情况,具有一定临床实用价值,提出雏议,有待完善。
The traditional retinoblastoma (RB) four-point method is still not perfect. In fact, the development of this disease is not based on the four stages of the order, the transfer can occur in any stage: and the sub-classification of the lack of a unified standard. According to the clinical and pathological data of a large group of patients (154 cases) and long-term follow-up, there were extra-spherical outbreaks in more than 70.0% of glaucoma cases, with less than 10.0% <0.01): The follow-up results also showed that the mortality was significantly higher than the intraocular phase, with statistical significance (P <0.05). Therefore, a definite case of Qingguang is an extra-ocular category: RB secondary ocular hypertension can be considered as early clinical symptoms of extracancerous tumor spread. Combined with the literature review, a new classification of RB stage is proposed on the basis of four-stage method, which provides a reliable basis for formulating the treatment plan and estimating the prognosis (see attached table). The current concise, easy to grasp, practical, applicable to the situation in our country, has some clinical practical value, put forward prevarication, to be perfected.