Objective To observe the expression of molecules on surface of dendritic cells (DC) in retinoblastoma (RB) patients, and investigate its relationship with immune function. Methods The peripheral blood of 50 normal subjects (control group) and 18 RB patients (RB group) were collected to proliferate the DC.The mixed lymphocyte reaction was performed on DC of the control and RB group to detect the antigen-presenting ability. The DC of control group was cultured in the supernate of SO-RB50 with the different concentration of 25% (group A), 50% (group B) and 75% (group C). Then the expression of HLA-DR, CD54 and CD80 on surface of DC were detected by flow cytometry (FCM). Results The Results of MLR showed that DC antigen-presenting ability was gradually enhanced with the increase of stimulation of the cell. And the DC antigen-presenting ability of the control group was superior to that of the RB group (P＜0.05). The expression of HLA-DR, CD54 and CD80 on surface of DC in the control group (12.14plusmn;2.52, 34.89plusmn;5.12, 10.93plusmn;3.1) were significantly higher than that in the RB group (7.33plusmn;2.20, 25.28plusmn;4.54, 7.89plusmn;3.75) (t=4.07, 3.96, 2.59; P＜0.05). The expression of HLA-DR, CD54 and CD80 on surface of DC in the group A, B and C (HLA-DR: 9.95plusmn;2.55, 6.48plusmn;1.82, 3.11plusmn;1.47; CD54: 34.75plusmn;4.92, 21.25plusmn;3.44,15.41plusmn;3.52; CD80: 9.15plusmn;2.18,5.05plusmn;2.01,2.90plusmn;1.10) were reduced in varying degrees compared with the control group; and with the increase of the concentration of supernate SO-RB50, the reduction was more evident (F=8.96,13.62, 20.72; P＜0.05). Conclusions The expression of molecules on surface of DC in RB patients is lower than that in the normal subjects. It is closely related to the functional deficiency of DC.
ObjectiveTo observe the effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival (DSS) for advanced retinoblastoma (RB). MethodsForty-one patients with advanced RB who received enucleation were enrolled in this study. There were 26 males and 15 females, age at diagnosis was ranged from 2 to 72 months, with a mean of 23.08 months. There were 16 bilateral patients and 25 unilateral patients; 13 group D eyes and 28 group E eyes. 16 patients received enucleation as the primary treatment (operation group), 25 eyes received chemotherapy before enucleation (chemotherapy group). There was no significant statistical difference between two groups for the gender, unilateral and bilateral, international staging or diagnostic age (P>0.05). The histopathology report was performed to assess the risk of postoperative tumor-node-metastasis staging (pTNM) in each patient, and the extent of tumor invasion in the optic nerve, choroid and anterior chamber was divided into 3 levels of low risk, medium risk and high risk. Five deaths were all in the group E with chemotherapy before enucleation. Using R software survival analysis software package survfit function, the application of Kaplan-Meier estimation method, DSS of RB children was calculated from the time of diagnosis, up to the date of the death of patient. DSS differences between chemotherapy, operation group and eye removal time (more than 3 months, less than 3 months) in group E RB children were analyzed. ResultsThe proportion of high risk pTNM stage in chemotherapy group was significantly lower than the operation group. But there was no significant difference between the two groups in the overall risk classification (χ2=3.130,P=0.077). For group D eyes, the overall risk classification in chemotherapy group was significantly lower than the operation group (χ2=5.870,P=0.015). There was no significant difference between the two groups in the overall risk of group E eyes (χ2=0.020,P=0.889). The DSS in chemotherapy group and operation group were 0.71 and 1.00, respectively; the difference was significant (χ2=3.700,P=0.05). The DSS in children whose enucleation delayed for more than 3 months and children whose enucleation performed within 3 months were 0.64 and 1.00, respectively; the difference was significant (χ2=4.800,P=0.028). ConclusionSystemic chemotherapy did not reduce the risk of tumor invasion and metastasis in patients with advanced RB. Instead, it will reduce the DSS in group E eyes of RB.
Objective To observe the application and effectiveness of bevacizumab intravitreal injection as adjunctive treatment for laser coagulation to treat retinopathy of prematurity (ROP). MethodsFrom March 2008 to October 2010, 17 infants (31 eyes) with ROP received bevacizumab intravitreal injection and were analyzed. Ten infants were male (18 eyes) and 7 were female (13 eyes).Their gestational age was from 24.7 to 31.0 weeks, with a mean of (28.2±1.9) weeks. Their birth weight was from 750 to 1600 grams, with a mean of (1150±264) grams. The indications for treatment included poor papillary dilation and refractive media opacity precluding complete laser coagulation and that ROP could not be controlled after complete laser coagulation treatment. The duration of followup was 1.4 to 40.8 months, with a mean of (20.8±13.2) months. It was noted whether the diseases were completely controlled or not, unfavourable structural outcome occurred or not and if there were complications regarding treatment. Results During the follow-up of all 31 eyes, ROP of 27 eyes (87.0%) was controlled by bevacizumab intravitreal injection as adjunctive treatment for laser coagulation. Increasing neovascularization and traction retinal detachment occurred in 2 eyes (6.5%). These 2 eyes underwent vitreoretinal surgery. The posterior retinal structure returned to normal in 1 eye and posterior vitreoretinal traction occurred in 1 eye. After bevacizumab intravitreal injection ROP continued progressing and traction retina detachment occurred in 2 eyes. The overall health of this infant remained good during and after operation. No systemic adverse drug reactions were found. No endophthalmitis occurred. No ocular complications such as corneal burn, cataract, and anterior segmental ischemia were found. Conclusions During the follow-up，the effectiveness of bevacizumab intravitreal injection as adjunctive treatment for laser coagulation to treat ROP was positive. No complications regarding the treatment were found.
Objective To investigate the incidence of retinopathy of prematurity (ROP) in extremely low birth weight infants and to explore their risk factors. Methods ROP screening was carried out in Shenzhen Eye Hospital from July 2006 to October 2011. One hundred and fortyfive infants with a birth weight less than 1000 grams were respectively analyzed. There were 93 males and 52 females. Their average gestational age was (28.5±2.0) weeks and average birth weight was (923.0±85.0) grams. The more advanced ROP stages during the follow up or between the 2 eyes of bilateral patients were recorded and analyzed in this study. All infants were first divided into ROP group or non-ROP group. All the ROP cases were further divided into mild ROP group and severe ROP group. Mild group included infants with stage 1, stage 2 and nonthreshold stage 3 ROP. Severe group included infants with pre-threshold type 1, threshold, aggressive posterior ROP and stage 4/5 ROP. Gestational age (less than or equal to 28 weeks or more than 28 weeks), birth weight (less than 750 grams or more than or equal to 750 grams), fetus number in one birth (single or multiple fetus), mode of delivery (normal or cesarean section delivery) and gender were analyzed as risk factors according to reference. SPSS 13.0 was used to do the statistical analysis. Results96/145 infants developed ROP with an incidence of 66.21%. There were 59 (40.69%) severe ROP infants who underwent laser coagulation, bevacizumab intravitreal injection or vitreoretinal surgery. The difference of gestational age, fetus number in one birth, mode of delivery between ROP group and non-ROP group was statistically significant (P＜0.05). The difference of gestational age between mild ROP group and severe ROP group was statistically significant (χ2=7.588,P=0.006).Logistic regression analysis showed that only gestational age related to ROP occurence［Exp（B）=0.328 07,P=0.005 19］. Conclusions The incidence of ROP and severe ROP are very high in extremely low birth weigh infants. ROP risk factors are various and mainly include gestational age less than or equal to 28 weeks, multiple fetus and normal delivery.