原发性结膜肿瘤728例临床病理分析

目的 了解眼部原发性结膜肿瘤的组织病理学特征及发病率.方法 收集第三军医大学附属西南眼科医院2003年1月至2009年12月期间门诊及住院治疗的728例原发性结膜肿瘤的临床病理资料进行回顾性分析.结果 良性结膜肿瘤570例(78.3%),其构成位于前10位的依次为:色素痣、结膜囊肿、乳头状瘤、血管瘤、迷芽瘤(皮样瘤、皮样脂肪瘤、畸胎样瘤)、脂肪瘤及纤维脂肪瘤、反应性淋巴增生、黑变病、非典型性增生、皮脂腺瘤.恶性结膜肿瘤158例(21.7%),其构成位于前5位的分别是:鳞状细胞癌(含黏液表皮样癌)、恶性淋巴瘤、恶性黑色素瘤、浆细胞瘤、原位癌.对结膜鳞状细胞性肿物及黑色素性病变的临床、病理特征及鉴别诊断进行了总结分析.结论 结膜肿瘤临床及病理分类繁多,对病变进行临床及病理分析有助于正确的诊断及治疗.     

葡萄膜与结膜色素性肿瘤核仁组成区银染定量研究

目的：评价银染核仁组成区(AgNORs)和计算机图像分析技术在结膜与葡萄膜色素性肿瘤良恶性鉴别诊断或冒后评估上的价值． 方法：应用AgNORs和计算机图像分析技术对44例葡萄膜恶性黑色素瘤、10例结膜色素痣及10例结膜恶性黑色索瘤进行检测。 结果：结膜恶性黑色素瘤较色素痣AeNORs面积显著增加(P<0.05)；葡萄膜恶性黑色索瘤AgNORs面积则按梭形细胞型、混合细胞型及上皮样细胞型顺序增加(P<0.05). 结论：AeNORs技术可能有助于结膜黑色素瘤良恶性的鉴别诊断，井可作为葡萄膜恶性黑色索瘤预后评价的参数之一。 （中华眼底病杂志，1995，11：181-184）     

原发性结膜肿瘤728例临床病理分析

目的 了解眼部原发性结膜肿瘤的组织病理学特征及发病率.方法 收集第三军医大学附属西南眼科医院2003年1月至2009年12月期间门诊及住院治疗的728例原发性结膜肿瘤的临床病理资料进行回顾性分析.结果 良性结膜肿瘤570例(78.3%),其构成位于前10位的依次为:色素痣、结膜囊肿、乳头状瘤、血管瘤、迷芽瘤(皮样瘤、皮样脂肪瘤、畸胎样瘤)、脂肪瘤及纤维脂肪瘤、反应性淋巴增生、黑变病、非典型性增生、皮脂腺瘤.恶性结膜肿瘤158例(21.7%),其构成位于前5位的分别是:鳞状细胞癌(含黏液表皮样癌)、恶性淋巴瘤、恶性黑色素瘤、浆细胞瘤、原位癌.对结膜鳞状细胞性肿物及黑色素性病变的临床、病理特征及鉴别诊断进行了总结分析.结论 结膜肿瘤临床及病理分类繁多,对病变进行临床及病理分析有助于正确的诊断及治疗.

Abstract：

Objective To investigate the histopathologic features and incidence of primary conjunctival neoplasms. Methods The histopathologic data of 728 primary conjunctival neoplasms in Southwest Eye Hospital from January of 2003 to December of 2009 were collected and analyzed retrospectively. Results Benign conjunctival neoplasms were 570(78.3%), the top ten in the ranking in turn were pigmented nevus, conjunctival cyst, papilloma, hemangioma, Choristoma, lipoma and lipofibroma, Reactive Lymphoid Hyperplasia,melanosis, atypical hyperplasia, sebaceous adenoma. Malignant conjunctival neoplasms were 158(21.7%), the top five in the ranking in turn were squamous cell carcinoma, malignant lymphoma, plasmocytoma, carcinoma in situ. The clinical, pathological and differential diagnosis of conjunctival squamous cell neoplasms and melanin lesions were summarized. Conclusions The classification of conjunctival neoplasms are various, the clinical and pathological analysis of primary conjunctival neoplasms is helpful to the diagnosis and therapy.     

777例原发性眼结膜肿瘤

目的:原发性眼结膜肿瘤的组织病理学分析。方法:常规石蜡包埋切片及HE染色,少数作PAS、网状纤维及免疫组化检查。结果:777例原发性结膜肿瘤中良性肿瘤(669例(86.1％),恶性肿瘤108例(13.9％)。良性肿瘤中色素痣247例(36.9％),其他依次为囊肿、皮样瘤及纤维脂肪瘤等。恶性肿瘤中鳞状细胞癌58例(53.7％),恶性黑色素瘤占第二位。结论:结膜良、恶性肿瘤某些生物学特性的差别,可作为鉴别诊断的参考。结膜的鳞状细胞癌中还有梭形细胞癌和粘液表皮样癌的病理类型及恶性黑色素瘤术后复发有多种病理因素。眼科学报 1995;11:211—215。     

结膜原发性肿块422例的临床病理探讨

目的:分析结膜原发性肿块的病理学特点,探讨部分肿块发生的过程及病因,提高结膜肿块诊断的准确性.方法:回顾性分析422例结膜肿块的临床表现、组织学特点及免疫组化结果,复习文献.结果:原发性结膜肿块422例中,良性肿块403例(95.5%),恶性肿块19例(4.5%).良性肿块中,鳞状细胞乳头状瘤71例(17.6%),结膜囊肿68例(16.9%),炎性肿块62例(15.4%),色素痣60例(14.9%), 皮样脂肪瘤58例(14.4%).恶性肿块中,B细胞淋巴瘤6例(31.6%),黑色素瘤6例(31.6%),鳞状细胞癌5例(26.3%).部分肿块的发生有共同的诱因.结论:结膜原发肿块病理类型丰富,部分病理类型间有一定相关性,以良性肿块为主.为保证病理诊断的准确性,降低误诊率,应在形态学的基础上结合免疫组化检查确诊.     

26例结膜黑色素瘤的临床和病理学特点

目的 总结结膜黑色素瘤临床和病理学特点,以利于早期正确诊断和治疗.方法 回顾性系列病例研究.对天津市眼科医院从1985年5月至2007年6月间收治的26例结膜黑色素瘤的临床和病理学特点进行回顾性分析.病理学检查采用常规石蜡切片、HE染色,S-100蛋白和HMB-45免疫组织化学染色.结果 26例患者年龄30.0～83.0岁,平均53.4岁;均为单眼发病.26例中,11例起源于结膜原发性获得性黑变病恶变、8例起源于结膜色素痣或黑色素细胞瘤恶变、7例为原发性结膜黑色素瘤;14例肿瘤累及到睑结膜和球结膜、6例肿瘤位于球结膜、4例肿瘤位于睑结膜、2例肿瘤位于角膜缘;22例为上皮样细胞型黑色素瘤、4例为上皮样瘤细胞和梭形瘤细胞混合型.7例原发性黑色素瘤中有3例为无色素性黑色素瘤,瘤细胞对S-100蛋白和HMB45呈阳性表达.大多数肿瘤表面和邻近的结膜上皮内伴有瘤细胞侵犯.术后随访到14例,随访时间为1～18年.其中12例在肿瘤切除术后有1～3次肿瘤复发,3例有耳前淋巴结转移,1例有同侧耳前淋巴结和双侧颌下淋巴结转移,4例死于肿瘤全身扩散或肝转移.结论 结膜黑色素瘤主要是起源于结膜原发性获得性黑变病或色素痣恶变,大部分为上皮样细胞型黑色素瘤,伴有邻近结膜上皮内侵犯.术后复发比较常见,尤其肿瘤范围较大或伴有PAM者.     

睫状体占位病变23例临床病理分析

目的 探讨睫状体占位病变的临床特点和组织病理学特征,为临床提供诊断和治疗依据.方法 从1981～2007年问收治的23例睫状体占位病变患者的临床和病理资料进行回顾性分析.结果 23例睫状体占位病变均为肿瘤,位于睫状体的病变14例(60.87%),位于睫状体和脉络膜的病变9例(39.13%).按组织来源分类:色素细胞来源肿瘤18例(78.26%),其中恶性黑色素瘤16例(69.56%),黑色素细胞瘤2例(8.70%);神经源性肿瘤2例(8.70%),髓上皮瘤和神经鞘瘤各1例(4.35%);睫状体神经上皮来源肿瘤1例(4.35%),为无色素上皮腺瘤;平滑肌瘤1例(4.35%);鳞状细胞癌1例(4.35%).结论 睫状体占位病变以恶性黑色素瘤居首位,了解其临床特征,辅助检查和组织病理学特点,有助于作出准确的诊断和处理.     

703例眼表肿瘤临床分析

目的：了解眼表肿瘤的发病情况及其诊疗现状，以期提高临床诊断的准确率。方法：回顾性分析、统计1993年1月至2002年12月间在我院就诊，并经病理证实的703例眼表肿瘤的临床病理资料。结果：良性肿瘤10种，587例(83．5％)，其构成依次为：结膜囊肿、色素痣、乳头状瘤、皮样瘤、血管瘤、皮样脂肪瘤、粘液瘤、角化棘皮瘤、错瘤、神经纤维瘤；恶性肿瘤4种。116例(16．5％)，其构成依次为：鳞癌、恶性黑色素瘤、原位癌、淋巴瘤。恶性肿瘤的门诊首诊正确诊断率仅60％。另有242例临床疑诊为眼表肿瘤，经病理证实为淀粉样变性、肉芽肿等炎症、变性性疾病。并对容易混淆的常见眼表疾病的鉴别要点作了概述。结论：作为发病率较高的眼病，眼表肿瘤理应得到眼科医生的足够重视，唯此才能提高诊断的准确率。     

原发性眼睑肿瘤291例临床病理分析

目的:了解原发性眼睑肿瘤的组织病理学特征及发病率。方法:收集第三军医大学附属西南眼科医院2003-01/2009-12门诊及住院治疗的291例原发性眼睑肿瘤患者的临床病理资料进行回顾性分析。结果:良性眼睑肿瘤172例(59.1%),其构成位于前10位的依次为:乳头状瘤、色素痣、炎性肉芽肿、皮样囊肿或表皮样囊肿、淀粉样变性、疣、血管瘤、黄色瘤、浆细胞肉芽肿、毛发上皮瘤。恶性眼睑肿瘤119例(40.9%),其构成位于前5位的肿瘤依次为:基底细胞癌、鳞状细胞癌(含梭形细胞癌)、皮脂腺癌、恶性淋巴瘤、恶性黑色素瘤。对眼睑三大恶性肿瘤的临床流行病学资料进行了总结分析,讨论了眼睑肿瘤切除术后的眼睑修复方法。结论:眼睑肿瘤临床病理分类繁多,对病变进行临床病理分析有助于正确的诊断及治疗。     

2010-2019年167例经局部切除术治疗的睫状体肿物的临床组织病理构成分析

目的 分析局部切除的睫状体肿物的临床组织病理类型构成。设计 回顾性病例系列。研究对象 2010-2019年北京同仁医院经局部切除术治疗的睫状体肿物167例。方法 回顾睫状体肿物的病理记录,包括一般临床信息和病理诊断。分析睫状体肿物的组织病理类型构成比。主要指标 组织病理类型构成比。结果 167例睫状体肿物中黑色素细胞瘤44例（26.3%）,无色素上皮腺瘤/腺癌32/2例（20.4%）,黑色素瘤29例（17.4%）,神经鞘瘤14例（8.4%）,平滑肌瘤12例（7.2%）,胶质神经瘤11例（6.6%）,髓上皮瘤9例（5.4%）,色素上皮腺瘤7例（4.2%）,血管瘤2例（1.2%）,炎症2例（1.2%）,色素痣、淋巴瘤和颗粒细胞病变各1例（0.6%）。其中,恶性病变占24.6%（41/167）,良性病变占75.4%（126/167）。睫状体上皮层起源的肿物占36.5%,基质起源的肿物占63.5%;上皮层起源的肿物前三位分别为无色素上皮腺瘤、髓上皮瘤、色素上皮腺瘤;基质起源的肿物前三位分别为黑色素细胞瘤、黑色素瘤、神经鞘瘤。有色素肿物和无色素肿物数量相当（49.7%和50.3%）;有色素肿物的前三位分别为黑色素细胞瘤、黑色素瘤和色素上皮腺瘤;无色素肿瘤的前三位分别为无色素上皮腺瘤、神经鞘瘤和平滑肌瘤。结论 本研究较大样本的睫状体肿物中占前三位的病理类型是黑色素细胞瘤、无色素上皮腺瘤、黑色素瘤。恶性肿瘤仅占四分之一,提示在选择治疗方案时要优先考虑肿瘤局部切除术。（眼科, 2020, 29： 391-395）     

伊朗亚兹德地区眼眶肿瘤的病理及人群分布调查

目的：回顾1997／2007伊朗亚兹德地区的200例眼及附属器肿瘤的流行病学特征，确定肿瘤的人群分布及肿瘤位置。方法：回顾观察性病例报道。我们回顾1997／2007医院组织病理学确诊为眼眶肿瘤的病例，分析200例连续病例的年龄分布、病理学、肿瘤来源及肿瘤位置。结果：患者200例（男111例，女89例），其中110例（55．0％）为良性肿瘤，86例（43．0％）为恶性，4例（2．0％）为转移性肿瘤。119例（59．5％）为眼睑肿瘤，21例（10．5％）为眼眶，60例（30．0％）位于眼球。最常见的恶性肿瘤是基底细胞癌（BCC）（25．5％）、鳞状细胞癌（SCC）（6．0％）及黑素瘤（5．5％）。各种类型的痣（15．0％）、皮样囊肿（5．5％）、血管瘤（5．0％）是最常见的良性肿瘤。200例患者按年龄分为两组，18岁以上及18岁以下。18岁以下患者中，最常见的是良性肿瘤（90．1％），恶性肿瘤及转移性肿瘤分别占8．4％和1．5％。然而，18岁以上患者，常见的是恶性肿瘤（51．1％），良性肿瘤占47．1％，转移性肿瘤占1．8％。结论：眼眶肿瘤的病理学特征与患者的年龄及肿瘤在眼及附属器的位置有关。在进行活检及肿瘤切除术之前，患者的发病年龄和肿瘤位置可成为我们制定治疗方案的前提，也是预后评估的重要信息。     

55例眼表黑痣样肿物的临床及病理分析

目的：分析结膜和角膜表面黑痣样肿物的临床特征及组织病理学特点,并探讨其治疗方法。方法对2012年1月到2015年3月收治并经病理学证实的55例（55只眼）结膜及角膜表面黑痣样肿物患者的临床特征、病理类型、手术方法及治疗效果进行回顾性分析。结果55例结膜及角膜表面黑痣样肿物中,黑色素痣患者48例,恶性黑色素瘤7例。对55例患者行手术切除联合术中冰冻病理控制切缘,且对7例恶性黑色素瘤进行术后局部和全身化疗。术后随访1年,48例黑痣复发2例,经再次手术切除联合病理检查显示为黑色素瘤。7例黑色素瘤中3例复发,及时切除后联合化疗效果稳定。结论通过对病理样本的病理学特征分析,有助于临床对眼表黑痣样肿物的诊断和治疗。     

65岁及以上老年人眼部肿瘤784例病理学诊断构成分析

目的分析65岁及以上老年人眼部肿瘤的临床病理诊断构成情况。设计回顾性病例系列。研究对象2002年1月至2015年12月天津市眼科医院存档并经手术治疗后病理检查确诊的65岁及以上老年人眼部肿瘤患者784例(795眼)的临床资料。方法回顾分析肿瘤的发生部位、病理诊断及构成情况。主要指标病理诊断及构成比。结果784例眼部肿瘤中,男性375例(47.8%)381眼(47.9%)。眼睑肿瘤564例(71.9%),其中良性肿瘤407例(72.2%),恶性肿瘤152例(27.0%)。泪囊区肿瘤9例(1.2%)。眼表肿瘤117例(14.92%),其中良性肿瘤94例(80.3%),恶性肿瘤13例(11.1%)。泪腺肿瘤18例(2.3%)。眼眶肿瘤66例(8.4%),其中良性肿瘤34例(51.5%),恶性肿瘤30例(45.5%)。眼内肿瘤10例(1.3%)。结论2002-2015年天津市眼科医院65岁及以上老年人眼部肿瘤以眼睑和眼表肿瘤多见。眼部恶性肿瘤发生部位以眼睑和眼眶多见。恶性肿瘤病理类型主要为基底细胞癌、皮脂腺癌和淋巴瘤等。     

Amniotic Membrane Transplantation for Conjunctival Tumor

Purpose:To evaluate the possibility of amniotic membrane transplantation (AMT) for the treatment of conjunctival tumor.Methods:Preserved AMT was performed in 26 patients (26 eyes) with conjunctival tumor, including 9 eyes (34.62％) with malignant tumor (conjunctival malignant melanoma, corneal and conjunctival squamous cell carcinoma, conjunctival lymphoma), 17 eyes (65.38％) with benign tumor(conjunctival papilloma, conjunctival dermoid tumor, conjunctival nevus, hemangioma etc.).Result:All the patients are followed up for 1～53 months. No acute rejection was observed after preserved AMT. Ideal healing was found in conjunctiva wound.Conclusion:Preserved AMT is a very effective method to repair wound after giant conjunctival tumor operation. Complete removal of tumor and perfect fixation are the key of ocular surface reconstruction. Eye Science 2003;19:165-167.     

A retrospective study of 2228 cases with eyelid tumors

AIM: To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS: In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin: epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS: Most eyelid tumors were epidermal in origin (1080, 48.5%), followed by miscellaneous (885, 39.7%) and adnexal tumors (263, 11.8%). Among all the tumors, 292 (13.1%) were malignant lesions, 1910 (85.7%) benign and 26 (1.1%) premalignant lesions. Most malignant tumors originated from epidermal cells (60.0%), followed by adnexal cells (34.6%). The most common malignant tumors were basal cell carcinomas (56.5%) followed by sebaceous carcinoma (34.6%), squamous cell carcinomas (3.8%) and lymphoma/plasmocytoma (1.7%). The benign and premalignant eyelid lesions mostly originated from epidermal cells (46.4%) followed by miscellaneous cell sources (45.2%), including melanocytic nevus (33.8%), seborrheic keratosis (13.7%), squamous cell papilloma (13.0%) and epidermal cysts (11.5%). CONCLUSION: Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.     

Clinical analysis of benign eyelid and conjunctival tumors

PURPOSE: To assess the relative frequency and clinicopathologic characteristics of benign conjunctival tumors. METHODS: A retrospective study of 80 consecutive patients admitted to our hospital with benign eyelid and conjunctival tumor between April 2000 and November 2002 was undertaken, and clinical records including age, sex and involved site of tumors and pathology slides of the patients were reviewed retrospectively. RESULTS: Twenty-three males and 33 females presented with benign eyelid tumors and 12 males and 12 females with conjunctival tumors. Mean age was 42.3 and 29.7 years, respectively. The lower eyelid was involved in 27 (48.2%) of eyelid tumors and the medial conjunctiva in 14 (58.3%) of conjunctival tumors. The most frequent tumor was intradermal nevus (44.6%), seborrheic keratosis (16.1%) and compound nevus (10.7%) in eyelid tumors, and compound nevus (29.2%) and intradermal nevus (25.0%) in conjunctival tumors. CONCLUSION: This report will provides a basic analysis of benign eyelid and conjunctival tumors.     

Treatment of large conjunctival nevus by resection and reconstruction using amniotic membrane

Background Nevus of the bulbar conjunctiva is a benign pigmented lesion of the ocular surface. Unless a biopsy is required for ruling out malignant melanoma, a nevus is usually excised for cosmetic reasons only. However, with large lesions involving two or more quadrants of the bulbar conjunctiva, a total resection can be difficult. In this report, we present a case of a huge nevus treated by surgical excision and amniotic membrane transplantation for reconstruction of the bulbar conjunctiva.Methods A 54-year-old Japanese man was referred to our clinic with suspected malignant tumor of the bulbar conjunctiva in his right eye. A large and diffuse pigmented tumor with numerous small cysts was present mainly on the upper bulbar conjunctiva. Resection of the conjunctival tumor and amniotic membrane transplantation for reconstruction of the bulbar conjunctiva were performed.Results The histopathological diagnosis was conjunctival nevus. Epithelialization of the bulbar conjunctiva over the amniotic membrane sheet was completed 4 weeks after resection. At 44-month follow-up, there was no recurrence or any postoperative complication.Conclusion Surgical resection combined with reconstruction by amniotic membrane transplantation is effective for the treatment of large conjunctival nevus.     

Clinicopathological analysis of 719 pediatric and adolescents’ ocular tumors and tumor-like lesions: a retrospective study from 2000 to 2018 in China

AIM: To analyze the retinal proteomes with and without conbercept treatments in mice with oxygen-induced retinopathy (OIR) and identify proteins involved in the molecular mechanisms mediated by conbercept. METHODS: OIR was induced in fifty-six C57BL/6J mouse pups and randomly divided into four groups. Group 1: Normal17 (n=7), mice without OIR and treated with normal air. Group 2: OIR12/EXP1 (n=14), mice received 75% oxygen from postnatal day (P) 7 to 12. Group 3: OIR17/Control (n=14), mice received 75% oxygen from P7 to P12 and then normal air to P17. Group 4: Lang17/EXP2 (n=21), mice received 75% oxygen from P7 to P12 with intravitreal injection of 1 μL conbercept at the concentration of 10 mg/mL at P12, and then normal air from P12 to P17. Liquid Chromatography-Mass Spectrometry (LC-MS)/MS data were reviewed to find proteins that were up-regulated after the conbercept treatment. Gene ontology (GO) analysis was performed of conbercept-mediated changes in proteins involved in single-organism processes, biological regulation, cellular processes, immune responses, metabolic processes, locomotion and multiple-organism processes. RESULTS: Conbercept induced a reversal of hypoxia-inducible factor 1 signaling pathway as revealed by the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and also induced down-regulation of proteins involved in blood coagulation and fibrin clot formation as demonstrated by the Database for Annotation, Visualization and Integrated Discovery (DAVID) and the stimulation of interferon genes studies. These appear to be risk factors of retinal fibrosis. Additional conbercept-specific fibrosis risk factors were also identified and may serve as therapeutic targets for fibrosis. CONCLUSION: Our studies reveal that many novel proteins are differentially regulated by conbercept. The new insights may warrant a valuable resource for conbercept treatment.