眼部肿瘤及瘤样病变7910例临床病理学分析  

A clinicopathological classification analysis of ocular mass lesions in 7910 cases

作　　者：王琳艳 陈丽荣[2] 戴喜哲 曹静 高涛[1] 姚克[1] 叶娟[1] Wang Linyan;Chen Lirong;Dai Xizhe;Cao Jing;Gao Tao;Yao Ke;Ye Juan(Department of Ophthalmology,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China;Department of Pathology,the Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院眼科中心,杭州310009 [2]浙江大学医学院附属第二医院病理科,杭州310009

出　　处：《中华眼科杂志》2019年第11期847-853,共7页Chinese Journal of Ophthalmology

摘　　要：目的探讨南方地区眼部肿瘤及瘤样病变的病变部位、组织病理学类型及组织胚胎学来源的分布情况。方法回顾性系列病例研究。收集2000年1月至2018年5月浙江大学医学院附属第二医院眼科收治的7910例患者的眼部肿瘤及瘤样病变组织标本进行病理学分析,观察眼部肿瘤及瘤样病变在不同解剖学部位、组织病理学类型及组织胚胎学来源的构成比。结果7910例患者中男性3445例,女性4465例,年龄3个月至106岁。按解剖学部位分类:7910例患者中眼睑病变占首位,共4976例(62.9%),其中良性病变前3位依次为色素痣(31.7%,1342/4235)、鳞状细胞乳头状瘤(12.3%,519/4235)、脂溢性角化病(9.4%,396/4235),恶性病变前3位依次为基底细胞癌(48.5%,359/741)、睑板腺癌(34.4%,255/741)、鳞状细胞癌(12.3%,91/741);眼表病变1449例(18.3%),其中良性病变前2位依次为色素痣(26.6%,359/1348)、鳞状细胞乳头状瘤(12.8%,173/1348),恶性病变前2位依次为淋巴瘤(34.7%,35/101)、鳞状细胞癌(30.7%,31/101);眼眶病变1485例(18.8%),其中良性病变前2位依次为血管瘤(28.5%,332/1167)、泪腺(导管)囊肿(13.2%,154/1167),恶性病变前2位依次为淋巴瘤(44.7%,142/318)、腺样囊性癌(10.1%,32/318)。按组织胚胎来源分类:7910例患者中上皮组织来源占首位,为2145例(占27.1%),皮肤附属器来源378例(4.8%),囊肿类1068例(13.5%),间叶来源748例(9.5%),淋巴造血来源225例(2.8%),神经来源31例(0.4%),黑素细胞肿瘤1765例(22.3%),其他1550例(19.6%)。结论18年间浙江大学医学院附属第二医院诊治的眼部肿瘤及瘤样病变,以眼睑多发,以上皮组织来源多见;眼睑、眼表良性肿瘤均以色素痣、鳞状细胞乳头状瘤居多,眼眶良性肿瘤以血管瘤、泪腺(导管)囊肿、表皮样囊肿居多;恶性肿瘤在眼睑以基底细胞癌居多,在眼表、眼眶以淋巴瘤居多。Objective To investigate the anatomical region,histopathological classification and histogensis distribution of ocular mass lesions in South China.Methods Retrospective cases study.The clinical and pathological data of 7910 samples with ocular(adnexal)tumors or proliferative lesions which were examined from January 2000 to May 2018 were retrospectively retrieved.The constituent ratios of ocular mass lesions in different anatomical regions and histogenesis have been analyzed.Results There were 3445 males and 4465 females aged from 3 months to 106 years.Classification by anatomical region.Eyelid 4976 cases(62.9%):benign-pigmented nevus(31.7%,1342/4235),squamous cell papilloma(12.3%,519/4235),seborrheic keratosis(9.4%,396/4235);malignant-basal cell carcinoma(48.5%,359/741),sebaceous gland carcinoma(34.4%,255/741),squamous cell carcinoma(12.3%,91/741).Ocular surface 1449 cases(18.3%):benign-pigmented nevus(26.6%,359/1348),squamous cell papilloma(12.8%,173/1348);malignant-lymphoma(34.7%,35/101),squamous cell carcinoma(30.7%,31/101).Orbit 1485 cases(18.8%):benign-hemangioma(28.5%,332/1167),lacrimal gland(duct)cyst(13.2%,154/1167);malignant-lymphoma(44.7%,142/318),adenoid cystic carcinoma(10.1%,32/318).Classification by histogenesis:epithelial 2145 cases(27.1%),cutaneous appendages 378 cases(4.8%),cystoid 1068 cases(13.5%),mesenchymal 748 cases(9.5%),lymph-hematopoietic 225 cases(2.8%),neurogenic 31 cases(0.4%),melanocytic 1765 cases(22.3%),others 1550 cases(19.6%).Conclusions Over the past 18 years,the ocular tumors identified at the Second Affiliated Hospital,Zhejiang University School of Medicine most frequently occur in eyelid and originate from epithelium.The most common types are as followings.Benign lesions:pigmented nevus,squamous cell papilloma are the most common types for eyelid and ocular surface,whereas hemangioma,lacrimal gland(duct)cyst and epidermoid cyst are the most common types for orbit.Malignant cancers:basal cell carcinoma is the most prevalent disease in eyelid,whereas lymphoma occurs more frequen

关 键 词：眼肿瘤 组织学类型肿瘤 回顾性研究 疾病谱 

分 类 号：R73[医药卫生—肿瘤]