泪腺上皮性肿瘤261例的临床和组织病理学特点分析

目的研究泪腺上皮性肿瘤的病理类型和临床特征。方法收集261例经病理诊断为泪腺上皮性肿瘤患者的273份石蜡切片标本,结合患者的组织病理学和临床相关资料进行归纳分析,探讨不同类型泪腺上皮性肿瘤的病理学特点及临床表现。结果泪腺上皮性肿瘤中各种类型所占比例由高向低排列依次为多形性腺瘤(混合瘤)(62．3％)、泪腺囊腺癌(22．3％)、多形性腺癌(8．8％)及泪腺腺癌(4．0％)等。术后复发12例,总复发率为4．6％;死亡4例,死亡率为1．5％。结论泪腺上皮性肿瘤死亡率较低,但复发率较高。应根据临床资料和病理诊断决定治疗用药和术后处理,而以手术治疗为主。

Clinical and pathological features of 273 cases of lacrimal epithelial tumors

OBJECTIVE: A retrospective study of histopathological and clinical aspects of 261 cases of lacrimal tumors (273 paraffin specimens) from Ophthalmic Pathology Laboratory, Beijing Tongren Hospital (Dec. 1961 to Jun. 2002) was performed to investigate the pathological classification and clinical features of these tumors. METHODS: Clinical features were analyzed from 261 patients of lacrimal tumors, including patient's history, age, gender, laterality, visual acuity, ultrasound B scan, X-ray, CT, MRI, pre- and post-operation condition, follow-up data and others. These data were compared with the pathological features. RESULTS: Pleomorphic adenoma was the most common tumor in epithelial tumors of lacrimal gland, followed by adenoid cystic carcinoma, pleomorphic adenocarcinoma and adenocarcinoma. Recurrence was observed in 12 cases. The recurrence rate is 4.6%. Four cases was dead, the mortality was 1.5%. CONCLUSION: Pleomorphic adenoma shows a low mortality and a relatively high recurrence rate. The main treatment for pleomorphic adenoma is surgical treatment. It is important to have a correct clinical diagnosis, to select the proper surgical method, drug treatment and postoperative management based on the pathological diagnosis, which can result in a decrease of recurrence rate.