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目的 :探讨视网膜母细胞瘤 (Retinoblastoma,RB)患儿发病年龄与肿瘤细胞分化程度及其与预后的关系。方法 :光镜下观察 2 91名患儿的 2 97只眼球的病理切片 ,并追踪观察患儿的预后。将肿瘤细胞的分化程度分为四级 ,即肿瘤细胞完全未分化 (Do) ;分化的肿瘤细胞所占的范围 <1/ 3肿瘤面积 (D1) ;1/ 3～ 2 / 3肿瘤面积 (D2 ) ;>2 / 3肿瘤面积 (D3)。结果 :年龄小于 6个月 ,肿瘤细胞分化最好 (D3) ,年龄介于 6～ 12个月者 ,肿瘤细胞分化较好 (D2 ) ,年龄大于 36个月 ,肿瘤细胞分化不良 (D1) ,年龄介于 2 4～ 30个月者 ,肿瘤细胞未分化 (Do)。四名 15～ 2 4个月的患儿死于肿瘤细胞转移 ,肿瘤细胞分化程度在 Do- D1。结论 :2岁以前患儿肿瘤细胞的分化程度较高。若在此年龄段患儿的肿瘤细胞分化不良 ,又同时伴有脉络膜浸润和 /或视神经浸润 ,应视为预后不好的指征
Objective: To investigate the relationship between the age of onset and the differentiation of tumor cells in children with retinoblastoma (RB) and its prognosis. Methods: The pathological sections of 2 97 eyes of 2 91 children under light microscope were observed, and the prognosis of children was observed. The degree of differentiation of the tumor cells was divided into four grades, that is, the tumor cells were completely undifferentiated (Do); the range of the differentiated tumor cells was <1/3 tumor area (D1); 1/3 to 2/3 tumor area );> 2/3 tumor area (D3). Results: The patients with less than 6 months of age had the best differentiation (D3), the age ranged from 6 to 12 months, the well-differentiated tumor cells (D2), the older than 36 months, the poorly differentiated tumor cells (D1) Aged between 24 and 30 months, undifferentiated tumor cells (Do). Four children 15 to 24 months died of tumor cell metastasis, the degree of tumor cell differentiation in Do-D1. Conclusion: The differentiation of tumor cells in children before the age of 2 is higher. If the poor differentiation of tumor cells in children at this age, accompanied by choroidal infiltration and / or optic nerve infiltration, should be considered as indications of poor prognosis