[Clinicopathologic features of retinoblastoma and expression of VEGF and Ki-67 after comprehensive treatment].

OBJECTIVE: To investigate the clinic pathologic features of retinoblastoma (RB) after comprehensive treatment, and study the expression of vascular endothelial growth factor (VEGF) in retinoblastoma treated with chemotherapy prior to enucleation. METHODS: Retrospective analysis was performed on retinoblastoma specimens obtained consecutively between 2006 and 2008 by enucleation, and patients' clinical information and clinic pathologic features were also collected. Immunohistochemical staining and real-time PCR were performed for the expression of VEGF. Immunohistochemical staining was also performed for Ki-67. RESULT: Among the 9 chemotherapy-treated cases, six belonged to group D and three to group E of IIRC. The reasons for enucleation included extensive vitreous seeds, RB recurrence, extensive subretinal fluid/seeds, vitreous hemorrhage and total tractional detachment of the retina. During the comprehensive treatment, the main tumors regressed in all eyes. The main tumors showed a mean decrease of 43.7% in the largest basal diameter and a mean decrease of 57.9% in thickness. The average interval between the end of chemotherapy and enucleation was 5.7 months. The reason for enucleation was the recurrence of main tumor, recurrence of new tumors, recurrent vitreous seed or subretinal seed. Three eyes showed a type 1 regression pattern, one eye showed a type 2 pattern, and the other five eyes showed type 3 clinical regression patterns. The expression of VEGF was lower in eyes that underwent planned enucleation than eyes that suffered from RB recurrence. CONCLUSIONS: The main reason for enucleation was extensive subretinal fluid/seeds after the comprehensive treatment. The type 3 clinical regression patterns were most common. In retinoblastoma, higher expression of VEGF may play an important role in the recurrence of retinoblastoma after comprehensive treatment.