伴皮肤溃疡形成的236例眼睑肿块临床病理分析

Clinical Pathological Analysis of 236Eyelid Masses with Skin Ulcer

目的分析伴皮肤溃疡眼睑肿块的病理学特点,进行临床及病理分析,探讨导致眼睑皮肤发生溃疡的病理类型及病因,提高眼睑肿块诊断的准确性。方法收集沈阳市第四人民医院1996年11月一2016年10月收治的4315例眼睑肿块切除病例,查阅电子病历,从中筛选出伴有眼睑皮肤溃疡的病例236例,回顾性分析其临床表现、组织学特点,复习文献。结果236例伴发溃疡肿块中,良性肿块125例(52.97%),前三位分别为炎性肉芽组织58例、角化棘皮瘤21例、皮肤脂溢性角化病17例;恶性肿块111例(47.03%),前三位分别为基底细胞癌62例、皮脂腺癌23例、鳞状细胞癌19例。良性肿块中,3.40%伴发皮肤溃疡;恶性肿块中,17.40%伴发皮肤溃疡;眼睑切除肿块中,5.47%伴有皮肤溃疡形成。部分肿块的发生有共同的诱因。结论伴皮肤溃疡的眼睑肿块病理类型丰富,良恶性肿块均可发生皮肤溃疡,但恶性肿块发生溃疡的几率较大。为保证诊断的准确性,降低误诊率,应在临床特点的基础上结合病理学检查确诊。

Objective To improve diagnostic accuracy for patients with eyelid masses through analyzing the clinicopathological characteristics and pathogenesis of eyelid masses with skin ulcer.Methods A total of 236 cases of eyelid masses with skin ulcer were screened from 4315 cases via looking up the electronic medical records.Clinical manifestations and histological characteristics were reviewed.Relevant literatures were reviewed.Results Of 236 eyelid masses with skin ulcer,benign eyelid masses were 125 cases(52.97%),the top three in the ranking were granulation tissue(58 cases),keratoacanthoma(21 cases),and seborrheic keratosis(17cases);malignant eyelid neoplasms were 111 cases(47.03%),the top three in the ranking were basal cell carcinoma(62 cases),sebaceous carcinoma(23 cases),squamous cell carcinoma(19 cases).In benign masses,3.40%of eyelid masses were accompanied by skin ulcer,in malignant masses,17.40%of eyelid neoplasms were accompanied by skin ulcer;and 5.47%of all eyelid masses were accompanied by skin ulcer.Different types of eyelid masses were induced by the same cause.Conclusion The pathological types of eyelid masses with skin ulcer are various.Although both benign and malignant masses can develop skin ulcers,the incidence of malignant tumors is higher.In order to ensure the accuracy of diagnosis and reduce the rate of misdiagnosis,the diagnosis should be made on the basis of clinical features and pathological examination.