2014年1月1日至2020年12月31日布卡武视网膜母细胞瘤的临床和组织病理学研究

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Ocular protrusion and ocular pain were the most frequent complaints on admission (51.2%). The extraorbital form was found in 59.2% of patients. The average time period between the first symptoms and the consultation was 6 months, and the time period between the first consultation and the beginning of management was 14 days. 112 patients (89.6%) had received enucleation combined with chemotherapy. The survival rate observed after 3 years of follow-up was 40.8%. There was a signifcative association between evolution of the retiboblastoma and the delay between consultation and the management, clinical form and management, and the treatment mode both in bivariate and multivariate analysis (p<0.05, CI=95%). Extraorbital retinoblastoma (61.6%), endophytic (74.4%), with classic cytology showing Flexner-Wintersteiner rosettes (96.3%), numerous mitoses (98.4), necrosis and calcification (92%) dominated. Images of infiltration of the internal structures of the eye were observed (18.4%). 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引用次数: 0

摘要

本研究的目的是确定在刚果民主共和国布卡武随访的视网膜母细胞瘤患者的组织病理学和临床特征。方法:本研究是一项横断面分析性研究,纳入了2014年1月至2020年12月在CELPA眼科诊所随访的视网膜母细胞瘤患者125例。采用Epi Info和SPSS 16.0软件对临床和组织病理学资料进行分析。结果:共咨询了7200例1-5岁儿童,其中视网膜母细胞瘤125例,发生率为1.7%。年平均发病率为13.8例。24个月以下年龄组占多数(54.4%),平均年龄24.6个月。绝大多数患者无视网膜母细胞瘤家族史(79.2%)。眼球突出和眼痛是入院时最常见的主诉(51.2%)。59.2%的患者出现眶外形态。首次出现症状至就诊的平均时间为6个月,首次就诊至开始治疗的平均时间为14天。112例(89.6%)患者接受了除核联合化疗。随访3年后生存率为40.8%。在双因素和多因素分析中,视网膜母细胞瘤的发生与会诊与治疗的延迟、临床形式与治疗的延迟、治疗方式的延迟均存在显著相关性(p<0.05, CI=95%)。眼眶外视网膜母细胞瘤(61.6%),内生(74.4%),典型细胞学表现为Flexner-Wintersteiner玫瑰座(96.3%),大量有丝分裂(98.4%),坏死和钙化(92%)为主。观察到眼睛内部结构的浸润图像(18.4%)。结论:视网膜母细胞瘤是一种高度恶性的儿童肿瘤,在布卡武仍然是一个真正的公共卫生问题。晚期和严重的组织学形式最为常见。早期诊断和治疗对改善预后至关重要。在我们有限的条件下获得的40.8%的存活率是成功的开始,可以通过所有相关学科的参与来提高。
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Clinical and histopathological study of retinoblastoma in bukavu from 01 january 2014 to 31th december 2020
Introduction: The aim of this study was to determine the histopathological and clinical characteristics of retinoblastoma in patients followed in Bukavu, Democratic Republic of Congo. Methods: It is a cross-sectional and analytical study that included 125 consecutives, exhaustively included subjects followed for retinoblastoma at CELPA ophthalmology clinic from January 2014 up to December 2020. Clinical and histopathological data were analyzed with Epi Info and SPSS 16.0 software. Results: A total of 7200 children aged 1-5 years old were consulted, including 125 cases of retinoblastoma, representing a frequency of 1.7%. The mean annual incidence was 13.8. The age group under 24 months predominated (54.4%), with a mean age of 24.6 months. The majority of patients had no family history of retinoblastoma (79.2%). Ocular protrusion and ocular pain were the most frequent complaints on admission (51.2%). The extraorbital form was found in 59.2% of patients. The average time period between the first symptoms and the consultation was 6 months, and the time period between the first consultation and the beginning of management was 14 days. 112 patients (89.6%) had received enucleation combined with chemotherapy. The survival rate observed after 3 years of follow-up was 40.8%. There was a signifcative association between evolution of the retiboblastoma and the delay between consultation and the management, clinical form and management, and the treatment mode both in bivariate and multivariate analysis (p<0.05, CI=95%). Extraorbital retinoblastoma (61.6%), endophytic (74.4%), with classic cytology showing Flexner-Wintersteiner rosettes (96.3%), numerous mitoses (98.4), necrosis and calcification (92%) dominated. Images of infiltration of the internal structures of the eye were observed (18.4%). Conclusion: Retinoblastoma, a highly malignant tumor of children, remains a real public health problem in Bukavu. Advanced and severe histological forms were the most frequent. Early diagnosis and treatment are essential to improve the prognosis. A survival rate of 40.8% obtained in our limited conditions is a beginning of success which could be improved with the involvement of all the disciplines concerned.
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