结膜重度非典型增生局部癌变7例临床分析

发布时间：2018-06-13 00:03

本文选题：眼结膜 + 重度非典型增生　；参考：《眼科新进展》2014年05期

【摘要】：目的探讨眼结膜重度非典型增生局部癌变的临床特点及其治疗和预后。方法对我院眼科术后经病理检查确诊为结膜重度非典型增生局部癌变的7例(7眼)患者进行随访,随访1~15 a,平均8.2 a,对随诊及住院病历资料进行回顾性分析。7例结膜重度非典型增生局部癌变患者,其中3例行局部病变切除手术,对手术切除的瘤体行病理检查;4例行眶内容物摘出术。结果对手术切除的瘤体行病理检查结果显示:光镜下可见上皮的成熟仅限于表浅1/3,细胞核异型性显著的细胞从基底开始,超出中1/3进入上1/3。核分裂象多,可见于上皮各水平面,异常核分裂易见,胞浆量增多,嗜酸性增强,癌组织向间质浸润,形成不规则的癌巢,浸润细胞组成小芽,癌组织小芽浸润于间质中。3例行局部病变切除手术术后局部复发2例,再行眶内容物摘出术。4例行眶内容物摘出术后未见复发,未见其他部位转移。结论结膜重度非典型增生局部癌变的预防与解剖部位、累及范围、首次治疗方案等有关,早期诊断和选择最佳治疗方案是改善生存质量的重要手段。
[Abstract]:Objective to investigate the clinical features, treatment and prognosis of severe atypical hyperplasia of conjunctiva. Methods 7 cases of severe atypical hyperplasia of conjunctiva and 7 eyes of local carcinogenesis confirmed by pathological examination after ophthalmology operation in our hospital were followed up. The follow-up data of follow-up and hospitalization cases were analyzed retrospectively. Seven patients with severe atypical hyperplasia of conjunctiva were treated with local carcinogenesis, 3 patients with local lesions were resected. Surgical excision was performed in 4 cases with excision of orbital contents. Results pathological examination showed that the maturation of epithelium was limited to 1 / 3 of the epidermis, and the cells with significant nuclear heterogeneity began from the base and exceeded the middle 1 / 3 into the upper 1 / 3. There are many mitotic images, which can be seen in the horizontal level of the epithelium. Abnormal mitosis is easy to see, cytoplasm is increased, eosinophilic is enhanced, cancer tissue infiltrates into the interstitial, forms irregular cancer nest, and infiltrates cells to form buds. In 3 cases of tumor tissue infiltrating into the interstitial tissue, local recurrence was found in 2 cases after resection of local lesions, and no recurrence was found in 4 cases of orbital substance extraction after excision of orbital contents, and no metastasis was found in other sites. Conclusion the prevention of local carcinogenesis of severe atypical hyperplasia of conjunctiva is related to the anatomical location, the range of involvement, the first treatment plan, etc. Early diagnosis and selection of the best treatment plan are important means to improve the quality of life.
【作者单位】：铜仁市第一人民医院眼科;
【分类号】：R739.7

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