眼结膜肿物2 053例临床组织病理学分析  

The clinical and histopathological analysis of 2 053 cases of conjunctival neoplasms

作　　者：黄晶晶[1] 李彬[1] 梁庆丰[1] 项晓琳[1] 高飞[1] 张志豹[1] 

机构地区：[1]首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 北京市眼科学与视觉科学重点实验室,100005

出　　处：《中华眼科杂志》2016年第10期738-744,共7页Chinese Journal of Ophthalmology

摘　　要：目的 总结分析眼结膜肿物的临床组织病理学特点及分类.方法 回顾性系列病例研究.收集北京同仁医院眼科病理室2003年10月至2015年10月存档的2053例眼结膜肿物的临床及组织病理学资料.对所有标本结合其病理申请单进行临床及组织病理学分析,资料主要包括患者年龄、性别及组织病理学诊断.组织病理学分类参考Shields的分类方法的前提下,结合本病理室的诊断结果分为良性及恶性肿物两大类,将所有患者按年龄划分为0～17岁、18～39岁、40～59岁和60岁及以上共4组.结果采用x2检验进行统计学分析.结果 2 053例资料中男性1 025例,女性1 028例（男∶女=1∶1）.其中良性肿物1 660例（80.9％）,平均诊断年龄为30.5岁;癌前期病变及恶性肿物393例（19.1％）,平均诊断年龄53.3岁;二者平均发病年龄差异具有统计学意义（P＜0.01）.良性肿物中,位居前5位依次为色素痣、囊肿、皮样瘤和皮样脂肪瘤、炎性肉芽组织、鳞状细胞乳头状瘤;恶性肿物中,居前4位依次为上皮内瘤变（CIN）、黑色素瘤、淋巴瘤、鳞状细胞癌.其中囊肿、鳞状细胞乳头状瘤、原发性获得性黑变病、CIN以及淋巴瘤的男女构成差异均具有统计学意义（P均＜0.01）.此外,0～17岁最常见良、恶性肿物分别为皮样瘤和皮样脂肪瘤、黑色素瘤,18～39岁最常见良、恶性肿物分别为色素痣和淋巴瘤,40岁及以上最常见良、恶性肿瘤分别为囊肿和CIN.结论 眼结膜肿物以良性病变居多.其中良性肿物好发于年轻人,癌前期病变及恶性肿物好发于中老年人.色素痣和CIN分别为最常见的结膜良、恶性肿物.Objective We aimed to identify and describe the clinical and histopathologic characteristics of conjunctival neoplasms.Methods Retrospective case series study.We collected and analyzed the clinical and histopathologic data of the conjunctival neoplastic specimens including the age,gender,and histopathologic diagnosis of all patients obtained from Beijing Tongren Eye Center between October 2003 and October 2015.All the pathology diagnosis results were divided into two categories which were benign and malignant tumors,according to Shields histopathological classification methods and the pathology diagnosis resuhs in our department.All cases were divided into four groups as 0-17 years old,18-39 years old,40-59 years old,aged 60 and above.The chi-square test was used for statistical analysis.Results Of the 2 053 cases,1 025 were males and 1 028 were females （male∶female=1∶ 1）.1660 cases （80.9%） were benign and 393 cases（19.1%） were premalignant or malignant.The average age at diagnosis was 30.5 years for benign lesions and 53.3 years for premalignant and malignant lesions,which was significant different （P〈0.01）.The most common benign lesions were nevus,cysts,dermoids and dermolipomas,inflammatory granulomas and squamous cell papillomas.The most common premalignant and malignant tumors were CIN,melanomas,lymphomas and squamous cell carcinoma.The constitution of males and females of cysts,squamous cell papillomas,primary acquired melanosis,CIN and lymphomas were significant different （P〈0.01）.Moreover,the most common benign and malignant neoplasm were dermoids and dermolipomas,melanomas respectively in group under 18 years old.And nevus and lymphomas were the most common benign and malignant tumors respectively in patients between 18 and 39 years old.While cysts and CIN were the most common benign and malignant tumors respectively in cases over 40 years old.Conclusions The majority of tumors of the conjunctiva were benign,with the young people being most.The premalignant and malignant tumor

关 键 词：结膜肿瘤 癌前状态 痣 色素 原位癌 

分 类 号：R739.7[医药卫生—肿瘤]