【摘要】 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。更多还原

【Abstract】 The traditional 4-stage-classification of retinoblastoma (RB) seems to be not quite satisfactory. The disease, in fact, does not progress in such a way, and metastases may occur at any time. According to the clinicopathological analysis and a longterm follow-up in a serial cases (154), we found that the incidence of extra-ocular invasion of lesions in glaucomatous stage was more than 70％, and that the difference in mortality between stage Ⅰ and Ⅱ was statistically significant (p<0.05). So, glaucomatous stage should belong to the category of extra-ocular one. High ocular tension secondary to RB may be considered as an early clinical sign of the tumor extra-ocular extension. A new system of staging RB is therefore proposed to cover the whole spectrum of the disease and to offer a reliable guide to treatment and prognosis (table). We think it is simpler, more accurate and applicable to our country.更多还原