Clinicopathologic features and prognostic factors of malignant eyelid tumors

AIM:To investigate the clinical characteristics and prognosis of patients with malignant eyelid tumors.METHODS: This was a retrospective, non-randomized, clinical reviews. Between January, 2002 and December, 2011, 75 cases with histologically confirmed malignant eyelid tumors were evaluated. Patients’ charts were reviewed for clinical information, treatment procedure, and disease course. Survival analysis in terms of recurrence-free survival was performed using age, sex, location of tumor and histopathological type. The follow-up ranged from 1 to 78 months (mean=21 months).RESULTS: The 75 eyelid tumors included 35 basal cell carcinoma (BCC, 46.7%), 22 sebaceous gland carcinoma (SGC, 29.3%), 7 squamous cell carcinoma (SCC, 9.3%), 10 malignant melanoma (MM, 13.3%), and 1 Merkel cell carcinoma (MCC, 1.3%). Recurrence developed in 17 cases (22.7%). The recurrence rate of BCC (4/35, 11.4%) was significant lower than MM (6/10, 60.0%, P<0.001). The mean interval of recurrence was 21 months (range 3-62) for all eyelid tumors. Tumor located at canthus had higher recurrence rate (50%) compared with those located at eyelid (19%, P<0.05). Histological type was independent variable for recurrence by Cox regression analysis.CONCLUSION: It is important to achieve a negative tumor margin in canthus located malignant eyelid tumor. Clinicians should have a high level of suspicion for recurrence according to histological type when treating patients with eyelid tumor.     

Temporary amniotic membrane patch for the treatment of primary pterygium: mechanisms of reducing the recurrence rate

Purpose The purpose of the study was to evaluate the outcome of the use of the temporary amniotic membrane patch (TAMP) for the treatment of primary pterygium and to investigate the mechanisms of reducing the recurrence rate.Methods Twenty eyes in 20 patients with primary pterygium underwent pterygium excision followed by TAMP for 5 days. Removed amniotic membrane (AM) was immunostained with primary antibodies CD34, c-Kit, STRO-1 and AC133.Results Within the period of follow-up (53.3±13.8 months), all the eyes showed a smooth ocular surface without recurrence of pterygium. Different grades of CD34, c-Kit, STRO-1and AC133 positive stem and progenitor cells infiltrated or attached to the stroma of patched AM, with more spindle-shaped c-Kit cells than ovoid-shaped CD34 and AC133 cells.Conclusion The temporary amniotic membrane patch is an effective and safe procedure for the treatment of primary pterygium. Absorbing excessive stem and progenitor cells may be one of the mechanisms of reducing the recurrence rate using AM.     

Bone marrow-derived progenitor cells promote corneal wound healing following alkali injury

Purpose To determine whether bone marrow-derived progenitor cells can be stimulated by inflammatory mediators and play a role in corneal wound healing following alkali injury. Methods Sixty rabbits were divided into two groups( Group I and Group II). Group I served as a bone marrow-suppression model, and received 200 mg/kg cyclophosphamide. Corneal alkali injury was created in one eye of each rabbit in each group; the other eye served as control. Three days after corneal burn, inflammatory cells in peripheral blood were counted. At the end of 4 weeks follow-up, corneas of all rabbits were subjected to histochemical examination to assess infiltrated CD34 and C-kit positive cells. Clinical outcome was determined at the end of 4 weeks. Results Cyclophosphamide suppressed bone marrow function in Group I by reducing cellularity by more than 30% and neutrophil distribution by 3.18 ± 1.83%. The number of bone marrow hematopoietic and mesenchymal progenitor cells were all suppressed by cyclophophamide, as demonstrated by statistically significant differences between Group I and Group II of CD34+ cells (t = −21.62, P < 0.01) and C-Kit cells (t = −21.62, P < 0.01). Fewer inflammatory cells were released into circulation in Group I (14.42 ± 5.70%) than in Group II (44.36 ± 8.64%). Clinical observation revealed that Group II rabbits had much greater reepithelization (t = 6.999, P < 0.01) and clearer corneas (X ² = 4.417, P < 0.01) than Group I. Conclusions Corneal alkali injury is a stimulus that induces a rapid bone marrow reaction to release not only inflammatory cells but also progenitor cells into circulation. Migrated bone marrow-derived progenitor cells can home to local sites to promote wound healing. Authors have no financial interest in any product or concept discussed in article. Grant: China National Scientific Fund 30500552. Research Fund of Health Bureau of Zhejiang Province, PR China. 2005QN006.