2000至2021年眼眶占位性病变1913例的临床病理学构成分析

A clinicopathological classification of space-occupying lesions of the orbit in 1913 patients from 2000 to 2021

目的探讨眼眶占位性病变的临床病理学构成情况。方法本研究为回顾性病例系列研究。收集浙江大学医学院附属第二医院2000年1月至2021年12月因眼眶占位性病变行切除手术的1 913例患者的1 913份组织标本资料进行病理学分析, 按照不同组织发生学类型、病变性质及年龄段分类, 分析其构成情况。结果 1 913例患者中, 男性913例(47.7%), 女性1 000例(52.3%);良性病变1 489例(77.8%), 恶性病变424例(22.2%)。按组织发生学类型分类:脉管性病变占首位, 为521例(27.2%), 囊肿性病变407例(21.3%), 淋巴增生性病变277例(14.5%), 泪腺来源182例(9.5%), 炎性反应病变121例(6.3%)。按病变性质分类:1 489例良性病变中, 海绵状血管瘤占首位(275例, 占全部患者14.4%), 其后依次为皮样囊肿225例(11.8%), 其他类血管瘤199例(10.4%), 表皮样囊肿136例(7.1%), 良性泪腺混合瘤134例(7.0%)。恶性病变中, 淋巴瘤210例(占全部患者11.0%), 皮脂腺癌47例(2.5%)。全部患者年龄范围0~90岁, 其中0~18岁儿童青少年247例(12.9%), 19~59岁中青年1 270例(66.4%), 60~90岁老年396例(20.7%)。结论 22年间浙江大学医学院附属第二医院诊治的良性眼眶占位性病变患者中, 约2/3为中青年, 男性略少于女性。在良性病变中, 海绵状血管瘤居首位, 其次是皮样囊肿和表皮样囊肿。眼眶恶性肿瘤中淋巴瘤居首位, 中老年人多见。

Objective To investigate the histopathological classification of orbital space-occupying lesions.Methods This is a retrospective case series study.The clinical and pathological data of 1913 tissue specimens from 1913 patients with space-occupying lesions of the orbit which were examined in the Second Affiliated Hospital,Zhejiang University School of Medicine from January 2000 to December 2021 were collected.The mass lesions were classified based on histogenesis,pathological nature and age.Results There were 913 males(47.7%)and 1000 females(52.3%).The lesions were benign in 1489 patients(77.8%)and malignant in 424 patients(22.2%).Based on histogenesis,there were 521 vasculogenic lesions(27.2%),which rancked first,407 cystoid lesions(21.3%),277 lymphoproliferative lesions(14.5%),182 lacrimal gland lesions(9.5%)and 121 inflammatory lesions(6.3%).By pathological nature,there were 1489 benign lesions,including cavernous hemangioma(275,14.4%),dermoid cyst(225,11.8%),other hemangiomas(199,10.4%),epidermoid cyst(136,7.1%)and benign mixed tumor of the lacrimal gland(134,7.0%),and 257 malignant lesions,including lymphoma(210,11.0%)and sebaceous gland carcinoma(47,2.5%).The age of all patients ranged from 0 to 90 years,while 247 lesions(12.9%)occurred in patients aged 0 to18 years,1270 lesions(66.4%)in patients aged 19 to 59 years,and 396 lesions(20.7%)in patients aged 60 to 90 years.Conclusions In 22 years,almost 2/3 benign orbital lesions in the Second Affiliated Hospital,Zhejiang University School of Medicine occurred in young and middle-aged patients,and males were fewer than females.The most common benign orbital tumors was cavernous hemangioma,followed by dermoid cyst and epidermoid cyst.And the most common malignant orbital tumor was lymphoma,which occurred more frequently in older patients.