眼表鳞状细胞瘤的药物治疗现状

Current status of medical therapy on ocular surface squamous neoplasia

眼表鳞状细胞瘤(OSSN)是眼表最常见的无色素肿瘤,手术切除是该类疾病最根本的治疗方式。"零接触"手术方式辅助冷冻疗法有助于避免肿瘤向周围组织扩散,但对于较大、累及视轴、复发性、多灶性或弥漫性病变,手术可能无法完全清除病灶,达不到理想的治疗效果,并且存在术后角膜缘干细胞缺乏、瘢痕形成和睑球粘连的风险。局部药物治疗由于药物接触整个眼表而具有明显优势,可以靶向治疗多灶性或弥漫性病变。应用较广泛的药物有5-氟尿嘧啶、丝裂霉素C和干扰素α2b三种,以及抗血管内皮生长因子药物、维甲酸、芦荟、西多福韦等。这些药物可以单独局部使用或者联合使用,也可以辅助术前减容、术后预防复发。了解OSSN的药物治疗现状有助于促进该领域研究。

Ocular surface squamous neoplasia(OSSN)is the most common unpigmented tumor on the ocular surface.Surgical resection is the most fundamental treatment."Non-contact"surgery assisted by cryotherapy is helpful to prevent the tumor from spreading to the surrounding tissue.However,for larger,axial,recurrent,multifocal or diffuse lesions,surgery may not be able to remove the lesions completely,leading to unsatisfactory therapeutic efficacy.Meanwhile,there is a risk of limbal stem cell deficiency,scar formation and symblepharon after surgery.Therefore,topical chemotherapy shows obvious advantages due to its action with the entire ocular surface,thus multifocal or diffuse lesions can be targeted for treatment.The most widely used drugs are 5-fluorouracil,mitomycin C,interferonα2b,and others including anti-vascular endothelial growth factor agents,retinoic acid,aloe,cidofovir,etc.,which can be applicated individually or in combination with each other.In addition,these medication also play an adjuvant role in preoperative treatment to reduce tumor volume as well as postoperative prevention of tumor recurrence.Better understanding of the pharmacological treatment of OSSN may promote the investigation in the future.