眼周肿物311例临床病理分析

Clinical and pathological analysis of 311 cases of periocular neoplasms

目的：探讨眼周常见肿物的临床病理学类型及分布情况。方法：回顾性分析自2008-2015年间在杭州市第三人民医院病理科存档的311例眼周肿物的临床组织病理学资料。结果：在311例眼周肿物病例中,男139例（占44.69%）,女172例（占55.31%）,年龄1~87岁;良性病变257例（占82.64%）,恶性及恶性倾向病变54例（占17.36%）。115例60岁以上患者中,恶性及恶性倾向病变43例（占37.39%）。良性病变前3位分别为寻常疣、皮内痣和脂溢性角化病;恶性及恶性倾向病变前3位分别是基底细胞癌、日光性角化病和鳞状细胞癌,平均发病年龄分别为66.85、79.33和68.83岁;恶性及恶性倾向病变主要发生在下睑（占29.63%）,其次分别为内眦、眉弓、上睑和外眦。结论：眼周组织重要而精细,易于发生肿物,其中基底细胞癌是最常见的眼周恶性肿瘤,对眼周肿物应常规做病理检查。

Objective： To investigate the common clinical and pathological classifi cations and the distribution of periocular neoplasms. Methods： A total of 311 periocular neoplasms verifi ed by the department of pathology at the third people＇s hospital of Hangzhou from 2008 to 2015 were included in this study. Results： There were 139 male（44.69%） and 172 female（55.31%） in the 311 periocular neoplasms. The age distribution was 1 to 87 years old. Two hundred and fi fty-seven（82.64%） of the lesions were benign, while 54（17.46%） of the lesions were malignant or having malignant tendency. In 115 patients over 60 years old, 43（37.39%） of them were malignant or having malignant tendency. The three leading benign lesions were verruca vulgaris, intradermal nevus and seborrheic keratosis; The three leading malignant lesions or lesions having malignant tendency were basal cell carcinoma, actinic keratosis and squamous cell carcinoma, the mean ages of occurrence of them were 66.85, 79.33 and 68.83 years old, respectively. The malignant lesions or lesions having malignant tendency were most commonly found on the lower eyelid（29.63%）, followed by medial canthus, arcus superciliaris, upper lid and lateral canthus. Conclusion： The periocular area is important and sophisticated, it is susceptible to neoplasms. Basal cell carcinoma is the most common periocular malignant tumor. Pathological examination should be performed for periocular neoplasms to guide the diagnosis and treatment in clinics.