泪腺多形性腺瘤的临床特征及研究现况

Clinical features and research status of the pleomorphic adenoma of the lacrimal gland

泪腺多形性腺瘤(LGPA)是一种常见的泪腺上皮性肿瘤,主要发生于眶部泪腺,其具体发生机制未明。LGPA平均发病年龄约为39.5岁,通常表现为泪腺区肿物和眼球突出,一般呈无痛性,若出现疼痛应警惕其是否发生了恶变。影像学检查对诊断LGPA具有重要价值,也可以为手术方案的制定提供重要参考。LGPA通常不进行术前活检,以防止包膜破损致肿瘤细胞溢出。LGPA治疗方法主要是手术切除,术中是否能完整切除肿瘤与肿瘤的复发和恶变密切相关。本文主要从LGPA的临床表现、组织病理学改变、医学影像学改变、肿瘤发生发展的分子机制、恶变机制、治疗、及预后等方面,对近些年国内外的研究成果进行了相关综述,以期为该病的诊疗提供一些参考。

Pleomorphic adenoma of the lacrimal gland(LGPA)is the most common epithelial lacrimal gland tumor,mainly occurring in the orbital lacrimal gland.The specific mechanism of its occurrence is unknown.The average onset age of LGPA is 39.5 years,and its clinical manifestations are usually lachrymal mass and exophthalmos,which are painless.If patients feel pain,malignant lesions should be considered.Imaging studies are of great value in the diagnosis of LGPA and can also be an important reference for the formulation of the surgical plan.To avoid capsule damage and tumor spillage,incisional biopsy isn't performed before surgery in LGPA.The treatment of LGPA is intact capsule excision.The risk of recurrence and malignant transformation is closely related to whether the tumor can be completely removed.This article reviews the clinical manifestation,histopathological changes,medical imaging changes,molecular mechanisms of tumor occurrence and development,malignant transformation mechanism,treatment and prognosis of LGPA in recent years from domestic and foreign research results,expecting to provide some references for the diagnosis and treatment of LGPA.