侵犯眼眶的鼻腔鼻窦恶性肿瘤临床和病理学特征  

Clinical and histopathological features of sinonasal malignancy with orbital invasion

作　　者：储杨[1] 刘红刚[2] 于振坤 

机构地区：[1]北京市门头沟区医院耳鼻咽喉科,北京102300 [2]首都医科大学附属北京同仁医院病理科,北京100730 [3]南京同仁医院耳鼻咽喉头颈外科,江苏南京211102

出　　处：《中国耳鼻咽喉头颈外科》2013年第8期396-399,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2009-3-31)

摘　　要：目的探讨侵犯眼眶的鼻腔鼻窦恶性肿瘤的临床病理学特征、治疗及生存率。方法收集1997年7月～2007年6月共93例侵犯眼眶的鼻窦恶性肿瘤的临床病理资料,分析统计其症状、原发部位、组织学类型、复发率和治疗方法。结果总生存率67.7%(63/93),3年内无瘤生存率40.9%(38/93),组织学类型及构成比分别为鳞状细胞癌最多44.1%(41/93)、其次为神经外胚层肿瘤14.0%(13/93),横纹肌肉瘤11.8%(11/93)。鳞状细胞癌和神经外胚叶肿瘤预后较好,横纹肌肉瘤预后最差,鳞状细胞癌和横纹肌肉瘤更易侵犯眼眶。结论侵犯眼眶的鼻腔鼻窦恶性肿瘤的早期诊断至关重要,行眶内容物剜除和术后的修复要慎重考虑,手术切除加术后放射治疗仍是目前最常用最有效的治疗方法。OBJECTIVE Sinonasal malignancy with orbital invasion is rare. The objective of this study was to evaluate the clinical and histopathological features, treatment outcomes and survival rates for these malignancies. METHODS The clinical data of 93 patients who were treated between 1997 and 2007 were reviewed retrospectively. Symptoms, location of lesions, previous recurrences, histological subtype, and treatment modalities were analyzed. RESULTS The overall survival was 67.7% （63/93） , 3-year disease-free survival rate was 40.9% （38/93） . Regarding the histopathological features of tumors, 44.1% （41/93） of the patient＇s had squamous cell carcinoma, 14.0% （13/93） had neuroectodermal carcinoma, and 11.8% （11/93） had rhabdomyosarcoma. According to pathology classification, patients with rhabdomyosarcoma had worse overall survival rate than whom with squamouscell carcinoma and neuroendocrine carcinoma. Squamous cell carcinoma and rhabdomyosarcoma invaded orbit more often, malignancy of nasal cavity invaded orbit more often than malignancy of sinus. CONCLUSION The early diagnosis of sinonasal malignancy with orbital invasion is crucial. The orbital exenteration and postoperative rehabilitation should be carefully considered. Surgical resection with postoperative radiation is the optimal treatment method.

关 键 词：鼻窦肿瘤 鼻腔 眼眶 预后 

分 类 号：R739.62[医药卫生—肿瘤]