眼眶炎性假瘤的临床病理特征分析及治疗效果观察  

Clinical pathologic analysis and therapeutic effects of orbital inflammatory pseudotumor

作　　者：赵莲[1] 陈建卓[1] 王红霞[2] 

机构地区：[1]解放军第101医院眼科,江苏省无锡市214044 [2]河北医科大学第二医院,河北省石家庄市050000

出　　处：《眼科新进展》2015年第8期759-761,共3页Recent Advances in Ophthalmology

基　　金：河北省卫生厅课题基金资助(编号:20130469)~~

摘　　要：目的探讨淋巴细胞浸润型和硬化型眼眶炎性假瘤(orbital inflammatory pseudotumor,OIP)的临床病理特征,以及手术切除联合皮质类固醇治疗硬化型OIP的疗效。方法选择32例淋巴细胞浸润型和54例硬化型OIP患者,检测血清中Ig G4的水平,组织病理分析Ig G4阳性细胞的表达情况。淋巴细胞浸润型OIP患者采取糖皮质激素治疗,硬化型OIP患者均进行手术切除联合低剂量糖皮质激素治疗。结果硬化型患者血清Ig G4水平(1.87±0.38)g·L-1明显高于淋巴细胞浸润型OIP患者(0.93±0.21)g·L-1,病理学检查结果显示淋巴细胞浸润型OIP中有2例表现为浆细胞Ig G4阳性,硬化型OIP患者中有26例表现为浆细胞Ig G4表达阳性;淋巴检查细胞浸润型OIP患者随访3 a内有2例复发,硬化型OIP患者经手术切除联合糖皮质激素治疗后,随访3 a无一例复发。结论在对OIP患者进行诊治时,应首先根据临床症状和病理检查明确病变类型,对于硬化型OIP患者应尽早行手术治疗,术后联合长期低剂量皮质类固醇治疗可明显改善硬化型OIP患者的临床症状,提高治愈率。Objective To analyze the clinical pathologic features of constrictive orbital inflammatory pseudotumor （OIP） and the synergetic effect of excision surgery and glucocorticoid for constrictive OIP. Methods A total of 32 cases of lymphocyte infiltrating OIP and 54 cases of constrictive OIP diagnosed by pathological examination were included in this study. The serum level of IgG4 and the IgG4 positive plasmocyte were examined. Lymphocyte infiltrating OIP patients received corticosteroids therapy, while the constrictive OIP patients received excision surgery and corticosteroids thera- py. Results The serum IgG4 level （ 1.87 ± 0.38 ） g L-1 in constrictive OIP were sig- nificantly higher than lymphocyte infiltrating OIP （0.93 ± 0.21 ）g L-1 , histopathologic results showed that IgG4 in 25 cases of constrictive OIP were positive, while 2 cases of lymphocyte infiltrating OIP were positive. Two cases of lymphocyte infiltrating OIP recurred in 3 years, while no recurrence was found for constrictive OIP. Conclusion In the diagnosis and treatment of OIP, pathological examination is recommended for determining the pathological pattern, for the constrictive OIP, the synergetic treatment of excision surgery and corticosteroids can significantly improve the clinical symptoms and increase the recovery rate.

关 键 词：硬化型眼眶炎性假瘤 糖皮质激素 淋巴细胞浸润型 

分 类 号：R735.2[医药卫生—肿瘤]