42例眼睑鳞状细胞癌临床组织病理学特点及预后相关因素分析

目的 分析眼睑鳞状细胞癌的临床及组织病理学特点，探讨影响眼睑鳞状细胞癌的临床预后因素。设计 回顾性病例系列。研究对象 安阳市眼科医院2000年1月至2011年3月42例（42眼）眼睑鳞状细胞癌患者。方法 依据原始记录和随访情况，对临床及组织病理学因素进行统计分析。采用COX回归分析复发相关因素，生存分析采用Kaplan-Meier法。术后随访（45.7±9.87）个月。主要指标 患者年龄、性别、病程、肿瘤解剖部位、肿瘤T分类、肿瘤病理学分级及治疗方法。结果 42例眼睑鳞状细胞癌患者平均年龄（61.9±7.82）岁；其中男24例（57.1%）；发病部位以下睑为多（18/42）；肿瘤T分类4例T1，7例T2，17例T3，14例T4。病程长、肿瘤T分类级别高是肿瘤复发的危险因素；肿瘤T分类与眼睑鳞状细胞癌患者的5年生存率呈相关性，T分类级别越高，肿瘤相关死亡率越高（r=8.818,P=0.035）。结论 眼睑鳞状细胞癌病程越长、肿瘤T分类级别越高时，肿瘤的复发率增高；肿瘤T分类级别越高时，肿瘤相关死亡率越高。（眼科，2018, 27：99-102）

Clinical and histopathologic features of eyelid squamous cell carcinoma and its prognostic predictors

Objective To analyze the clinical and histopathologic features and the factors associated with prognosis of the eyelid squamous cell carcinoma. Design Retrospective case series. Participants Forty-two cases of eyelid squamous cell carcinoma during January 2000 and March 2011 in Anyang Ophthalmology Hospital. Methods According to the initial records and follow-up feedback,  the clinical and histopathologic features were analyzed. The related factor of recurrence was analyzed by COX regression, and survival analysis using kaplan-meier method. The postoperative patients were followed-up for (45.7±9.87) months. Main Outcome Measures Age,  gender,  disease course,  disease region,  T classification,  pathological grade,  treatment methods. Results The age of 42 cases varied from 36 to 81 years old,  and the mean age was 61.9±7.82 years old. There were 24(57.1%) males and 18(42.9%) females. The tumors mainly located at the lower eyelid. The sample included four T1,  seven T2,  seventeen T3,  and fourteen T4 cases. The statistics analysis showed the length of the disease duration and the T classification were significantly associated with local recurrence(P＜0.05). The disease duration and the T classification were two risk factors for tumor recurrence. And the T classification was correlated with the five-year survival rate, the higher grade of T classification, the higher tumor-related mortality (r=8.818, P=0.035). Conclusion The clinical outcome of the eyelid squamous cell carcinoma is related with the length of the disease duration and the T classification of the tumor. The longer disease duration or the higher T classification,  predicted a higher recurrence rate of tumor. And the mortality rate increased with the higher T classification.（Ophthalmol CHN,  2018, 27：99-102）