手术切除联合冷冻治疗结膜鳞状细胞癌

Analysis of Operative Resection Combined with Liquid Nitrogen Frozen on 21 Patients with Conjunctival Squamous Cell Carcinoma

目的探讨手术切除联合液氮冷冻治疗结膜鳞状细胞癌的临床效果。方法分析1998年2008年收治的21例眼睑结膜鳞癌患者的临床资料。对肿瘤局限在眼球结膜和部分穹窿结膜受侵犯者行单纯手术切除联合液氮冷冻治疗;部分或全部结膜及眼睑受侵犯者行局部肿瘤切除联合眼睑重建及液氮冷冻治疗;眼睑和球结膜广泛受累,无法进行眼睑重建者行眼眶内容物剜除术。结果 21例中,7例行单纯肿瘤切除合并冷冻治疗,其中5例痊愈,2例复发;10例行局部肿瘤切除并进行眼睑重建,其中7例痊愈,3例复发,复发病例作眶内容摘除;4例肿瘤侵犯范围较宽而无法保留眼球者行眼眶内容物摘除。术手3例死于肝肺转移。结论眼睑结膜鳞状细胞瘤的外科手术切除是唯一有效的方法 ,眼睑重建视肿瘤侵犯范围而定,冷冻治疗作为辅助治疗可提高疾病的治愈率。

Objective To investigate clinical effects of operative resection combined with liquid nitrogen frozen cryotherapy on conjunctival squamous cell carcinoma. Methods Twenty-one patients with conjunctival squamous cell carcinoma admitted from 1998 to 2008 were retrospectively analyzed. The patients with carcinoma confined to bulbar conjunctiva and partially formix conjunctiva were treated with exairesis combined with liquid nitrogen frozen cryotherapy. Patients of partial or total conjunctiva and eyelid invasion were treated with exairesis combined with liquid nitrogen frozen cryotherapy and partial or whole eyelid reconstruction. Patients of conjunctiva and eyelid extensive being involved which can not be used eyelid reconstruction were treated with eye sockets resection combined with hydroxyapatite implantation. Results Seven patients treated with exairesis combined with liquid nitrogen frozen cryotherapy,five of which were cured and two relapsed. Ten patients were treated with exairesis combined with liquid nitrogen frozen cryotherapy and partial or whole eyelid reconstruction,seven of which wre cured and three relapsed. The relapsed cases were treated with eye sockets resection. Four patients of wide range tumor invasion,unable to reserve the whole eyeball,three of which were treated with eye sockets resection and hydroxyapatite implantation. In all the 21 patients,there were three patients died of liver and lung metastasis. Conclusion In the therapy of squamous cell carrinoma,surgical resection is the only effective method. The effect depends on the invasion range of tumor. Cryotherapy,serving as an adjuvant therapy,can improve the cure rate.