Factors affecting recurrence after surgical treatment in cases with ocular surface squamous neoplasia.
Factors affecting recurrence after surgical treatment in cases with ocular surface squamous neoplasia.
复制标题
眼表鳞状细胞瘤手术治疗后复发的影响因素
DOI：
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发表时间：
2019
影响因子：
1.4
通讯作者：
Mehmed Uğur Işık
中科院分区：
文献类型：
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作者：
Ibadulla Mirzayev;A. Gündüz;Funda Seher Özalp Ateş;Gökçen Özcan;Mehmed Uğur Işık
目的
评估导致眼表鳞状细胞瘤（OSSN）患者复发的危险因素。
方法
回顾性分析1999年2月至2018年8月期间接受治疗和随访的112例OSSN患者的记录。
结果
男性 67 例（59.8%），女性 45 例（40.2%）。就诊时的平均年龄为 63.7 岁（范围 22-87 岁）。 105 例（93.7%）例行部分板层巩膜结膜切除术（PLSC），7 例（6.3%）例因球部侵犯而行摘除术作为第一步治疗。除 PLSC 外，还使用了 78 只眼（74.3%）的冷冻疗法、57 只眼（54.3%）因角膜受累而进行的酒精上皮切除术，以及 17 只眼（16.2%）因眼表重建而进行羊膜移植。 10 名患者（9.5%）使用了局部丝裂霉素 C，4 名患者（3.8%）使用了锶 90 (Str-90) 治疗，因为手术切缘在组织病理学检查中呈肿瘤阳性。术后组织病理学诊断为鳞状细胞癌（52例）、原位癌（44例）、中度结膜上皮内瘤变（11例）和轻度结膜上皮内瘤变（5例）。平均随访 20.1 个月，观察到 21 例（18.8%）肿瘤复发。发现接受补充冷冻治疗的病例的复发率低于未接受冷冻治疗的病例（P<0.001）。无论如何都没有发生转移。
结论
在我们的系列中，在相对短期的随访中，OSSN 的复发率为 18.8%，总体全球挽救率为 90.2%。
AIM
To evaluate the risk factors leading to recurrence in patients with ocular surface squamous neoplasia (OSSN).
METHODS
The records of 112 patients with OSSN who underwent treatment and follow-up between February 1999 and August 2018 were reviewed retrospectively.
RESULTS
Totally 67 patients (59.8%) were male and 45 patients (40.2%) were female. The mean age at presentation was 63.7y (range 22-87y). Partial lamellar scleroconjunctivectomy (PLSC) was performed in 105 (93.7%) cases and enucleation was performed in 7 (6.3%) cases due to bulbus invasion as the first step treatment. Treatments used in addition to PLSC included cryotherapy in 78 eyes (74.3%), alcohol epitheliectomy in 57 eyes (54.3%) for presence of corneal involvement, and amniotic membrane transplantation in 17 eyes (16.2%) for ocular surface reconstruction. Topical mitomycin C was used in 10 patients (9.5%) and strontium-90 (Str-90) treatment in 4 (3.8%) patients because surgical margins were tumor positive at the histopathological examination. Postoperative histopathologic diagnoses were squamous cell carcinoma (52 cases), carcinoma in situ (44 cases), moderate conjunctival intraepithelial neoplasia (11 cases), and mild conjunctiva intraepithelial neoplasia (5 cases). At a mean follow-up of 20.1mo, tumor recurrence was observed in 21 (18.8%) cases. The rate of recurrence was found to be lower in cases that underwent supplemental cryotherapy compared to those that did not (P<0.001). There was no metastasis in any case.
CONCLUSION
In our series, the recurrence rate is 18.8% and overall globe salvage rate is 90.2% for OSSN at relatively short-term follow-up.