20例睑板腺癌的病例分析

一、前言睑板腺癌是原发于眼睑麦氏腺的恶性肿瘤。它虽然是比较少见的疾病,但在眼睑的恶性肿瘤中发病率却是相当高的。我院从1972年10月—1980年9月共收治经病理证实的眼睑恶性肿瘤50例,其中睑板腺癌20例占40％,居第一位。此种疾病早期在临床上难以与睑板腺囊肿区別,最易误诊。我院遇到的20例中有7例(35％)曾在外院诊为脸板腺囊肿而做了囊肿单纯刮除术(这当然不能完全排除当时就是单纯的囊肿)。本病晚期临床上又常与眼睑鳞癌或基底细胞癌相混淆。我院20例中有5例临床诊断为癌,1例为眼睑肿物,2例以疑似睑板腺癌而入院,诊断附合率占     

睑板腺癌切除并成形术二例

睑板腺癌为眼睑的恶性肿瘤 ,多发生于老年人 ,女较男多 ,上睑较下睑多。我院今年共收治 2例睑板腺癌 ,现报告如下 :1　病例报告例 1:女 ,5 0岁 ,干部。右眼上睑长肿块 1年多。曾在他院诊断为“睑板腺囊肿”并行手术 1次 ,现复发半月来我院。入院查 :右眼视力 1.0 ,上睑皮肤颜色正常 ,正中可触及一直径 0 .6cm大小肿块 ,睑结膜面粗糙 ,可见黄白色斑点 ,未破溃。取出肿物 1小块 ,送病理检查 ,报告为睑板腺癌。作好术前准备 ,在局麻下行上睑板腺癌切除术。肿块范围为上睑 1/ 4。将上睑肿块范围眼睑组织三角形全层切除 ,伤口睑板直接连续缝合 ,…     

眼睑恶性肿瘤控制性切除术后疗效观察

 【摘要】 目的 探讨控制性切除术对眼睑恶性肿瘤患者预后的影响。设计 回顾性病例系列。研究对象2011年1月至2015年12月河南省立眼科医院经病理诊断为眼睑恶性肿瘤并行控制性切除术的患者68例（68眼）。方法 收集患者的临床资料,随访其预后及肿瘤复发情况,分析眼睑恶性肿瘤控制性切术的治疗效果。主要指标  肿瘤分期、大小、手术、组织病理类型、复发情况。结果 68例（68眼）中眼睑基底细胞癌者39眼（57.3%）,睑板腺癌28眼（41.2%）,鳞状细胞癌者1眼（1.5%）。随访5~57个月,5例（7.4%）复发。39例基底细胞癌患者中1例（2.6%）术后2年复发;28例睑板腺癌患者中4例（14.3%）复发。所有随访到的无复发的63例患者中20例（31.7%）经组织病理检查,发现切除远端组织内仍残留肿瘤细胞,并行二次手术切除,至切除远端未见肿瘤细胞残留,行眼睑缺损修补术。结论 眼睑恶性肿瘤石蜡组织学控制切除术能有效降低患者的复发率,尽可能保留肿瘤周围正常的眼睑组织,有利于组织缺损修复。     

眼睑肿物44例临床分析

目的　探讨眼睑肿物的临床、病理学分类及手术方法。方法　回顾性分析 1996年～ 2 0 0 1年收治 4 4例眼睑肿物患者年龄分布及病理分类 ;结合病例讨论肿物切除及整形术应注意的问题。结果　恶性肿瘤中居前 2位者为基底细胞癌、睑板腺癌 ,良性肿瘤中居前 2位者为色素痣 ,血管瘤和多发性神经纤维瘤。 39例手术切除 ,2例睑板腺癌术后复发再手术 ,后愈合好 ,2例死亡 ,余患者疗效好。结论　对眼睑肿物进行分析有利于临床诊断以及指导治疗方案     

2734例眼睑肿物的临床病理分析

目的 探讨眼睑肿物的组织病理类型及其变化.方法 为回顾性系列病例研究.收集复旦大学附属眼耳鼻喉科医院眼科病理室从1993年1月至2005年12月间存档的眼睑肿物临床组织病理学资料进行分析.结果 眼睑病变的临床表现多样,病理类型繁多.在2734例眼睑肿物中,炎性病变1462例,占53.47%;肿瘤性病变1248例,占45.65%.眼睑肿瘤中,良性肿瘤875例,占71.11%;恶性肿瘤373例,占29.89%.恶性肿瘤前3位分别是基底细胞癌、皮脂腺癌(包括睑板腺癌和蔡氏腺癌)、鳞状细胞癌.平均发病年龄分别为64.16、63.30、60.38岁.基底细胞癌以60～70 岁年龄组为多.睑板腺癌在40岁以上各年龄组发病率均较高.结论 对眼睑肿物的病理分类和分型,有助于眼睑肿物的病理诊断,为疾病诊治提供了参考依据.     

石碳酸辅助治疗睑板腺囊肿的临床观察

目的:为提高睑板腺囊肿手术的成功率,探讨减少睑板腺囊肿复发的简易手术方法。方法:对950例睑板腺囊肿采用石碳酸涂睑板腺囊肿的囊壁,观察其疗效。结果:950例睑板腺囊肿均能达到破坏其囊壁的完整性,术后随访7d~6mo,无复发,达到根治目的。结论:石碳酸治疗睑板腺囊肿方法简易、并发症少,是较为理想的手术方法。     

石炭酸治疗睑板腺囊肿的临床观察

目的 为提高睑板腺囊肿手术的成功率，探讨减少睑板腺囊肿复发的简易手术方法。方法 对950例睑板腺囊肿采用石炭酸涂睑板腺囊肿的囊壁，观察其疗效。结果 950例睑板腺囊肿均能达到破坏其囊壁的完整性，术后随访7天-6个月，无复发，达到根治目的。结论 石炭酸治疗睑板腺囊肿方法简易、并发症少，是较为理想的手术方法。     

p16蛋白在睑板腺癌中的表达及相关性

目的:探讨p16在睑板腺癌(meibomian gland carcinoma,MGCA)中的表达及其生物学意义。方法:采用免疫组织化学方法(SP法),检测p16蛋白在65例石蜡包埋的睑板腺癌标本中的表达,并在不同分化程度及生物学行为的睑板腺癌之间进行比较。结果:睑板腺癌组织与癌旁组织中p16蛋白表达差异有显著性意义(P<0.05);睑板腺癌中,p16蛋白表达阳性率随组织学分级降低而降低,不同分化组中p16蛋白表达差异有显著性意义(P<0.01)。不同生物学行为睑板腺癌中p16蛋白表达差异显著,无复发组p16蛋白表达率显著高于复发转移组(P<0.01)。结论:睑板腺癌中p16蛋白表达异常提示其在睑板腺癌发生发展中起着重要作用。p16蛋白的表达缺失或失活是睑板腺癌发生的重要分子事件,并与睑板腺癌的分化程度、浸润能力及复发转移密切相关,可以为临床判断预后提供依据。     

基础麻醉在小儿睑板腺囊肿手术中的应用

目的:探讨基础麻醉下行小儿睑板腺囊肿手术的临床疗效,为治疗小儿睑板腺囊肿提供参考。方法:回顾性分析我院近3a来收治的56例睑板腺囊肿患儿的病例资料,所有患儿在基础麻醉下行睑板腺囊肿刮除术,并进行术后随访。结果:所有睑板腺囊肿患儿均治愈,无麻醉意外,均为一期手术愈合,局部包块消失。所有患儿均进行0.5a以上随访,无1例复发。结论:基础麻醉下行小儿睑板腺囊肿手术安全可靠,复发率低,患儿无痛苦,值得推广。     

p16蛋白在睑板腺癌中的表达及相关性(英文)

目的探讨p16在睑板腺癌(meibomian gland carcinoma,MGCA)中的表达及其生物学意义。方法采用免疫组织化学方法(SP法),检测p16蛋白在65例石蜡包埋的睑板腺癌标本中的表达,并在不同分化程度及生物学行为的睑板腺癌之间进行比较。结果65例睑板腺癌组织中53例表达p16蛋白,30例癌旁组织中29例表达p16蛋白,两者差异有统计学意义(χ2=10.548,P=0.014);睑板腺癌中,p16蛋白表达阳性率随组织学分级降低而降低,不同分化组中p16蛋白表达差异有显著性意义(χ2=15.000,P=0.001)。不同生物学行为睑板腺癌中p16蛋白表达差异显著,无复发组p16蛋白表达率显著高于复发转移组(χ2=24.890,P=0.000)。结论睑板腺癌中p16蛋白表达异常提示其在睑板腺癌发生发展中起着重要作用。p16蛋白的表达缺失或失活是睑板腺癌发生的重要分子事件,并与睑板腺癌的分化程度、浸润能力及复发转移密切相关,可以为临床判断预后提供依据。     

Meibomian gland adenocarcinoma with regional lymph node metastasis

Meibomian gland carcinoma of the eyelid is a common neoplasm which clinically simulates a benign condition of chalazion. Although growing slowly, metastasis to regional lymph nodes is frequent, at a rate of 17-28% in this country. Eleven (11) cases of Meibomian gland carcinoma with regional lymph node metastasis are reported, and the therapeutic modalities have been tailored to suit the individual cases, including full-thickness local excision, orbital exenteration, radical cervical dissection, and superficial parotidectomy.     

Masquerade of sebaceous gland carcinoma as a rapidly recurring "chalazion", a case report]

PURPOSE: Demonstration of the importance of surgical excision and histological examination in presence of an apparently harmless tumoral alteration of the eyelids. CASE PRESENTATION: We report the case of a 65 year old patient suffering from systemic lupus erythematosus who noted a tumoral lesion on his left lower eyelid. Suspecting a chalazion, his dermatologist simply performed a cauterization. Six weeks later, a recurrence of the tumor appeared at the same location, and again, cauterization was done. A few weeks later, the patient consulted our clinic with a polycyclic tumor of 5 mm in diameter, involving the lid margin of the temporal part of the lower left eyelid. The patient had only moderate signs of blepharitis. There were no palpable preauricular and cervical lymph nodes. Suspecting a malignant tumor, the entire tumoral lesion was removed surgically. HISTOPATHOLOGY: The histopathologic examination showed a highly differentiated sebaceous gland carcinoma, most probably originating from a meibomian gland. The margins of the excision were found to be tumor-free. DISCUSSION: Sebaceous cell carcinoma is a rare entity. Depending on its histological differentiation it can be highly malignant. Infiltrative, and can metastasize. The mortality may reach 30% if low differentiation is present. As illustrated in the present case, the lesion may masquerade a chalazion. Therefore, in case of atypical lesion of the eyelid region complete surgical removal followed by a histopathological examination should be performed.     

眼睑皮脂腺癌治疗的研究进展

眼睑皮脂腺癌是最常起源于睑板腺和睫毛皮脂腺的恶性肿瘤,居眼睑恶性肿瘤的第2位。由于其高复发率和高转移率,已经受到人们的重视。最新研究和临床经验表明,早期发现,早期诊断,以手术为主,化疗、放疗、冷冻为辅的综合性治疗是提高眼睑皮脂腺癌存活率的关键。但是,随着现代治疗手段的应用,逐渐倾向于避免眼眶内容摘除的保守性治疗方法,这些方法有望减少复发和转移的发生率。本文就眼睑皮脂腺癌的治疗新进展作一综述。     

Malignant eyelid tumours in Taiwan

AIMS: To describe the clinical characteristics of patients with eyelid cancers in Taiwan. METHODS: Between 1980 and 2000, 127 (58 males and 69 females) patients (mean age 62.6; range 10-91 years) with histologically confirmed eyelid cancers were retrospectively evaluated at the National Taiwan University Hospital and Far Eastern Memorial Hospital in Taiwan. Clinical data of all patients were reviewed from medical records. The mean follow-up period was 62.4 months (range 3-240) for 113 patients. RESULTS: The 127 eyelid cancers included 79 basal cell carcinomas (62.2%), 30 sebaceous gland carcinomas (23.6%), 11 squamous cell carcinomas (8.7%), five malignant melanomas (3.9%), one Kaposi's sarcoma (0.8%), and one metastatic cancer (0.8%). Tumours developed more commonly in the lower (37.0%) than the upper eyelid (33.9%). The clinical accuracy in predicting eyelid malignancy was 90.5%. Primary treatment modality was mainly surgical excision. The recurrence, metastasis, and mortality rates at 5 years were 15.2, 11.7, and 7.3%, respectively, for all eyelid malignancies. Rates of sebaceous gland carcinoma recurrence, metastasis, and mortality were significantly higher (P<0.05) than those of basal cell carcinoma. The mean interval of recurrence or metastasis after primary treatment was 26.3 months (range 4-112) for all eyelid cancers. CONCLUSIONS: Although basal cell carcinoma is the most common eyelid cancer in Taiwan, sebaceous gland carcinoma is also common. Of the two, basal cell carcinoma has a better prognosis and sebaceous gland carcinoma has a higher mortality and therefore should be treated much more aggressively. Long-term follow-up is needed after treatment of malignant eyelid tumours.     

眼睑恶性肿瘤的组织学控制性切除

报告眼脸恶性肿瘤81例进行组织学控制切除;20例进行单纯性切除。追踪结果显示:组织学控制切除之复发率比单纯切除明显降低,且能保存更多健康眼睑组织,有利于它的重建成形。肿瘤边缘与切除的最适宜距离在睑板腺癌为6～10毫米,在基底细胞癌为3～5毫米。     

眼睑恶性肿瘤切除术后重建方法的选择和长期疗效分析

目的总结眼睑恶性肿瘤手术切除后一期重建方法的综合应用并评估其长期疗效。方法回顾性病例研究。2005年至2008年于复旦大学附属眼耳鼻喉科医院住院手术的46例眼睑恶性肿瘤患者的临床资料,并对患者的一般情况,肿瘤的性质、部位、侵犯程度,以及手术的类型,术后外观,患者舒适度,生存率等进行分析、评估。结果眼睑前层缺损采用了各种皮片移植术、皮瓣滑行术、半圆形旋转皮瓣术、Glabellar瓣等方法修补,后层缺损采用了Hughes瓣、自体睑板移植、自体硬腭黏膜移植等方法修补,单独或综合采用各种眼睑重建技术。平均随访（59．7±12．9）个月（15．84个月）。5年、7年的生存率分别为94％、91％。2例出现轻度的眼睑内、外翻,1例卅现下睑倒睫,其余患者眼睑位置正常。87％的患者对外观和舒适度满意。结论综合采用眼睑重建技术为眼睑恶性肿瘤手术的一期重建奠定了基础,并取得了较好的疗效。但密切的临床随访不容忽视。     

眼睑肿块手术(附123例临床分析)

目的探讨眼睑肿块的临床及病理学分类。方法回顾性分析1979-1998年收检123例眼睑肿块。结果恶性肿瘤14例中居前2位者为基底细胞癌（8例,57％）,睑板腺癌（4例,29％）。良性肿瘤91例中居前2位者为乳头状瘤（38例,42％）,色素痣（35例,37％）。其他病变18例为炎性肉芽肿、睑板腺囊肿、眼睑结核和雀斑。结论对眼睑肿块进行分析有利于临床诊断。     

Topical antiglaucoma treatment with prostaglandin analogues may precipitate meibomian gland disease

The popular use of topical prostaglandin analogues (TPAs) in glaucoma patients has a well-documented association with changes in number, length, thickness, and growth pattern of eyelashes. A link between meibomian gland disease and seborrheic blepharitis resulting from topical administration of prostaglandin analogues has not been made to the authors' knowledge. A retrospective study of 43 patients presenting for incision and curettage of chalazion to the operating theatre over a 2-year period was performed. The patients' histories were reviewed to establish whether they were using TPAs for glaucoma at the time of surgery. Eight patients (19%) were using TPAs at the time of surgery. No patient had a history of eyelid margin disease before the commencement of TPAs. The exact pathogenesis of how meibomian gland disease is linked to TPA use is unclear. We postulate that the topical application of prostaglandin analogues may contribute to the formation of chalazion by acting directly to stimulate meibomian gland secretion. The authors present the findings of a preliminary case series showing a higher-than-expected incidence of patients using TPAs requiring surgical intervention for chalazion.     

Adenoid-zystisches Karzinom des Oberlids

Adenoid cystic carcinoma (ACC) is a rare epithelial malignancy, which tends to grow slowly. ACC is an intractable neoplasm due to its ability to invade perineural spaces. Local recurrence after excision is not unusual. ACC most commonly arises in the lacrimal gland. Very rarely, ACC originates from accessory lacrimal gland tissue. Here, we present a patient with a large ACC of the central upper eyelid, which had been misdiagnosed and treated as a chalazion without histological examination. Its origin most likely is an accessory lacrimal gland.     

眼睑板腺癌中端粒酶的表达及意义

目的:检测端粒酶在人眼睑板腺癌(meibomian gland carci-noma,MGCA)中的表达,探讨其在睑板腺癌发病机制中的作用,为其临床治疗提供新的思路。方法:选取18例睑板腺癌患者切除后的手术标本,采用PCR-ELISA法及PCR-PAGE法检测其端粒酶的含量及表达。结果:所选18例患者中端粒酶检测呈阳性表达16例(89%)。ELISA结果显示其中阳性病例中绝大多数呈中、高度表达,仅1例△A值<0.4,为低度表达。电泳结果显示为多少不等的梯形条带,其中16例显示为4条以上。结论:睑板腺癌患者端粒酶活性明显增高,可能是肿瘤发生、发展的重要原因之一,抑制端粒酶活性有可能成为睑板腺癌的新型疗法之一。