原发性结膜肿瘤728例临床病理分析

Clinical and pathological analysis of 728 primary conjunctival neoplasms

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.

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.