Eyelid Neoplasms

眼睑肿瘤
  • 文章类型: Journal Article
    目的:报告以铂类为基础的新辅助化疗(NACT)治疗眼睑和眼周皮脂腺癌(eSGC)的疗效。
    方法:对25例患者进行回顾性研究。
    结果:出现eSGC的平均年龄为59岁。平均肿瘤基底直径为46mm。按AJCC第8版分类,肿瘤属于T2(n=2,8%),T3(n=6,24%),和T4(n=17,68%);N1(n=12,48%);和M1(n=1,4%)。NACT与5-氟尿嘧啶(5-FU)和顺铂/卡铂在21(84%)/4(16%)患者中,分别。每位患者新辅助全身化疗的平均周期数为2(中位数,3).新辅助化疗后肿瘤基础体积的平均减少百分比为65%(中位数,60%)。NACT之后,12例(48%)患者接受手术治疗,6例(12%)患者行EBRT,4例(8%)接受辅助化疗。共有11例(44%)患者在治疗过程中失访,其中3人死于转移性疾病。16例患者随访时间≥3个月,11例(69%)患者肿瘤完全控制,14例(88%)局部肿瘤控制,在平均25个月的随访中,全球抢救人数为7人(44%)(中位数,7个月;范围,3至110个月)。在任何情况下都没有看到肿瘤复发。注意到一个(4%)严重的心脏毒性不良事件。
    结论:基于铂的NACT是具有晚期肿瘤和局部转移的eSGC的合适选择。不良事件很少见,在符合治疗的患者中,基于NACT的联合治疗提供全球挽救和全身肿瘤控制。
    OBJECTIVE: To report the outcomes of platinum-based neoadjuvant chemotherapy (NACT) for eyelid and periocular sebaceous gland carcinoma (eSGC).
    METHODS: Retrospective study of 25 patients.
    RESULTS: The mean age at presentation of eSGC was 59 years. The mean tumor basal diameter was 46 mm. By the 8th edition of AJCC classification, tumors belonged T2 (n = 2, 8%), T3 (n = 6, 24%), and T4 (n = 17, 68%); N1 (n = 12,48%); and M1 (n = 1, 4%). NACT with 5-fluorouracil (5-FU) and cisplatin/carboplatin was administered in 21 (84%)/4 (16%) patients, respectively. The mean number of cycles of neoadjuvant systemic chemotherapy per patient was 2 (median, 3). The mean percentage reduction of tumor basal volume after neoadjuvant chemotherapy was 65% (median, 60%). After NACT, 12 (48%) patients underwent surgical treatment, 6 (12%) patients underwent EBRT, and 4 (8%) underwent adjuvant chemotherapy. A total of 11 (44%) patients were lost to follow-up during the course of treatment, of whom 3 died from metastatic disease. In 16 patients followed up for ≥ 3 months, complete tumor control was achieved in 11 (69%) patients, local tumor control in 14 (88%), and globe salvage in 7 (44%) at a mean follow-up of 25 months (median, 7 months; range, 3 to 110 months). No tumor recurrence was seen in any case. One (4%) serious adverse event of cardiotoxicity was noted.
    CONCLUSIONS: Platinum-based NACT is a suitable option for eSGC with advanced tumors and locoregional metastasis. Adverse events are rare and in patients compliant with treatment, NACT-based combination therapy offers globe salvage and systemic tumor control.
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  • 文章类型: Journal Article
    局部复发预示眼睑皮脂腺癌(SC)预后不良。复发预测因素因研究而异。准确的复发估计对于眼睑SC的个体化治疗至关重要。本研究旨在确定复发预测因子,并开发用于眼睑SC个性化预测的列线图。
    我们进行了一项多中心回顾性队列研究。对418例连续的眼睑SC患者进行了图表回顾。所有患者均在初次手术后进行随访。采用多因素Cox回归分析探讨复发的独立预测因子。开发了用于复发预测的列线图,并通过Bootstrap重采样进行了验证。将预测准确性和辨别能力与肿瘤进行比较,节点,转移(TNM)分期系统。
    超过60个月的中位随访时间,167例(40%)患者局部复发。从诊断到复发的中位时间为14个月。1年累积复发率为18%。诊断延迟(危险比[HR]=1.01,95%置信区间[CI]=1.00-1.01,P=0.001),眼眶受累(HR=4.47,95%CI=3.04-6.58,P<0.001),Ki67(HR=1.01,95%CI=1.00-1.02,P=0.008)和术中冰冻切片控制的Mohs显微手术初始手术(HR=0.53,95%CI=0.35-0.80,P=0.003)是复发的独立影响因素。将这四个因素与pagetoid扩散相结合的列线图显示出令人满意的辨别能力(C指数=0.80-0.83;曲线下面积[AUC]=0.82-0.84),比较优于TNM分期(均P<0.05)。
    眼睑SC的复发率很高。建议早期发现和Mohs显微手术切除以控制复发。眼眶受累的患者,Ki67高表达,和pagetoid传播可能需要辅助措施。这个列线图提供了更准确的复发估计,帮助做出治疗决策。
    UNASSIGNED: Local recurrence predicts dismal prognosis in eyelid sebaceous carcinoma (SC). Recurrence predictors vary across studies. Accurate recurrence estimation is essential for individualized therapy in eyelid SC. This study aims to identify recurrence predictors and develop a nomogram for personalized prediction in eyelid SC.
    UNASSIGNED: We conducted a multicenter retrospective cohort study. Chart reviews were performed in 418 consecutive patients with eyelid SC. All patients were followed up after their initial surgery. Multivariate Cox regression was used to explore the independent predictors of recurrence. A nomogram for recurrence prediction was developed and validated with bootstrap resampling. The predictive accuracy and discriminative ability were compared with the Tumor, Node, Metastasis (TNM) staging system.
    UNASSIGNED: Over a median of 60-month follow-up, 167 patients (40%) had local recurrence. The median time from diagnosis to recurrence was 14 months. The 1-year cumulative recurrence rate was 18%. Diagnostic delay (hazard ratio [HR] = 1.01, 95% confidence interval [CI] = 1.00-1.01, P = 0.001), orbital involvement (HR = 4.47, 95% CI = 3.04-6.58, P < 0.001), Ki67 (HR = 1.01, 95% CI = 1.00-1.02, P = 0.008) and initial surgery of Mohs micrographic surgery with intraoperative frozen section control (HR = 0.53, 95% CI = 0.35-0.80, P = 0.003) were independent influencing factors of recurrence. A nomogram integrating these four factors combined with pagetoid spread displayed satisfactory discriminative ability (C-index = 0.80-0.83; area under the curve [AUC] = 0.82-0.84), which compared favorably than TNM staging (all P < 0.05).
    UNASSIGNED: The recurrence rate is high in eyelid SC. Early detection and primary resection with Mohs micrographic surgery are recommended in controlling recurrence. Patients with orbital involvement, high Ki67 expression, and pagetoid spread may require adjuvant measures. This nomogram offers more accurate recurrence estimates, aiding in therapeutic decision making.
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  • 文章类型: Journal Article
    眼睑默克尔细胞癌(MCCE)是一种罕见但侵袭性的神经内分泌肿瘤,具有显著的发病率和死亡率。本研究旨在调查与MCCE相关的生存趋势和人口统计学因素。2000-2019年,使用监控,流行病学,和最终结果(SEER)计划。
    病例按人口统计参数进行分析,疾病属性,和生存。通过专用的计算机化软件包进行统计分析。
    共发现349例MCCE,在此期间,占美国所有MCC病例的2%。值得注意的是,MCCE的发生率在研究期间保持稳定(p=.35).女性患者占56%,男性占44%。白人患者占90.8%,黑人患者占2.9%。MCCE发病率随年龄增加,大多数患者年龄在85岁以上(p<0.05)。在大都市地区和平均收入>75,000美元/年的人群中,发病率最高。收入与MCCE诊断的可能性相关(p<0.05)。对5年生存数据的分析显示,20%的患者在诊断后5年内因MCCE死亡。其中,大多数人在诊断后一年内死亡。
    与以前的报告一致,大多数病人是白人,女性,年龄85+。发病率与大都市环境和收入中位数相关。虽然大多数患者没有死于MCCE,大多数记录的死亡发生在诊断后1年内.
    UNASSIGNED: Merkel cell carcinoma of the eyelid (MCCE) is a rare yet aggressive neuroendocrine tumour associated with significant morbidity and mortality. This study aimed to investigate survival trends and demographic factors related to MCCE, 2000-2019, using the Surveillance, Epidemiology, and End Results (SEER) Program.
    UNASSIGNED: Cases were analysed by demographic parameters, disease properties, and survival. Statistical analyses were performed via a dedicated computerized software package.
    UNASSIGNED: A total 349 cases of MCCE were identified, accounting for 2% of all MCC cases in the United States during that time. Of note, the incidence of MCCE remained stable over the study period (p = .35). Female patients accounted for 56% of the cases, and males for 44%. White patients accounted for 90.8% of the the cases, and Black patients for 2.9%. MCCE incidence increased with age, with the majority of patients age 85+ (p < .05). Incidence was greatest in metropolitan areas and among those with median incomes >$75,000/year. Income correlated with likelihood of MCCE diagnosis (p < .05). Analysis of 5-year survival data showed 20% of the patients died due to MCCE within 5 years of diagnosis. Of these, the majority died within one year of diagnosis.
    UNASSIGNED: Consistent with previous reports, most patients were white, female, and age 85+.Incidence correlated with metropolitan environments and median income. While most patients did not die from MCCE, majority of recorded deaths occurred within one year of diagnosis.
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  • 文章类型: Journal Article
    背景:皮肤癌是全球最常见的癌症,也是最常见的眼周肿瘤。位于骨周区域的角质形成细胞癌(KC),比如眼周肿瘤,被认为是高危肿瘤。Mohs显微手术(MMS)被认为是治疗高风险KC的第一线,提供比常规广泛切除术更低的复发率。
    目的:描述在智利第三大学中心接受MMS治疗的眼周KC的临床病理特征。
    方法:单中心,位于眼周区域的KC患者的回顾性研究,在2017年至2022年之间进行了彩信。记录MMS细节。
    结果:纳入了113例眼周癌患者。平均年龄为59±13岁;52%为女性。最常见的位置是内侧can(53%),其次是下眼睑(30.1%)。最常见的BCC组织学是结节变异(59.3%)。关于MMS,平均分期数为1.5±0.7,54%的病例仅需1个分期即可达到清晰的边缘.迄今为止,没有复发的报道.最大直径大于8.5mm或43.5mm2的肿瘤更可能需要复杂的重建。
    结论:回顾性设计和SCC组患者数量相对较少。可能的选择偏差,作为更大或更复杂的案例,可能已直接转诊给眼整形外科医生。
    结论:本研究证实了MMS在眼周KCs治疗中的作用。大于8.5mm的眼周KCs可能需要复杂的重建。这些结果可用于在术前就诊期间为患者提供咨询。
    BACKGROUND: Skin cancer is the most frequent cancer worldwide and the most frequent periocular tumor. Keratinocyte Carcinomas (KC) located in periorificial areas, such as periocular tumors, are considered high-risk tumors. Mohs Micrographic Surgery (MMS) is considered the first line for the treatment of high-risk KC, providing a lower recurrence rate than conventional wide excision.
    OBJECTIVE: To describe the clinical-pathological features of periocular KC treated with MMS in a tertiary university center in Chile.
    METHODS: A single-center, retrospective study of patients with KC located on the periocular area, that underwent MMS between 2017‒2022. MMS details were recorded.
    RESULTS: One hundred thirteen patients with periocular carcinomas were included. The mean age was 59 ± 13 years; 52% were women. The most frequent location was the medial canthus (53%), followed by the lower eyelid (30.1%). The most frequent BCC histology was the nodular variant (59.3%). Regarding MMS, the average number of stages was 1.5 ± 0.7, and 54% of the cases required only 1 stage to achieve clear margins. To date, no recurrence has been reported. Tumors larger than 8.5 mm in largest diameter or 43.5 mm2 were more likely to require complex reconstruction.
    CONCLUSIONS: Retrospective design and a relatively low number of patients in the SCC group. Possible selection bias, as larger or more complex cases, may have been referred to oculoplastic surgeons directly.
    CONCLUSIONS: The present study confirms the role of MMS for the treatment of periocular KCs. Periocular KCs larger than 8.5 mm might require complex reconstruction. These results can be used to counsel patients during pre-surgical visits.
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  • 文章类型: Meta-Analysis
    目的:探讨眼部黑色素瘤患儿(≤12岁)的临床表现及预后。
    方法:这是一个回顾性研究,采用个体参与者数据(IPD)荟萃分析汇集现有已发表病例的多中心队列研究,以及来自七个眼部肿瘤中心国际合作的未发表病例。
    结果:133例小儿脉络膜或睫状体患者的133只眼(n=66[50%]),虹膜(n=33[25%]),结膜(n=26[19%]),和眼睑(n=8[6%])黑色素瘤。总的来说,就诊时患者平均年龄为7岁(中位数,8;范围,1-12年),男性63人(49%)。肿瘤部位的平均年龄分别为6.50±3.90、7.44±3.57、9.12±2.61和5.63±2.38岁,对于脉络膜/睫状体,虹膜,结膜,和眼睑黑色素瘤,分别(P=0.001)。与眼黑素细胞增多症相关的比例为15%,11%,4%,0%,分别为(P=0.01)。眼部黑色素瘤家族史的频率没有因肿瘤部位而异(7%,17%,9%和12%,resp.[P=0.26])。经过74、85、50和105个月的平均随访(P=0.65),12%的患者出现转移,9%,19%,和13%的脉络膜/睫状体,虹膜,结膜,和眼睑黑色素瘤,分别。死亡报告为5%,3%,8%,0%,分别,生存分析表明脉络膜/睫状体和结膜黑色素瘤患者的死亡率更高。
    结论:眼部黑色素瘤在儿科人群中是罕见的,具有独特的临床特征和结果。虹膜黑色素瘤约占小儿葡萄膜黑色素瘤病例的三分之一。
    To investigate clinical manifestations and prognoses in pediatric patients (≤12 years old) with ocular melanoma.
    This was a retrospective, multicenter cohort study with individual participant data (IPD) meta-analysis pooling available published cases, and unpublished cases from an international collaboration of seven ocular oncology centers.
    There were 133 eyes of 133 pediatric patients with choroidal or ciliary body (n = 66 [50%]), iris (n = 33 [25%]), conjunctival (n = 26 [19%]), and eyelid (n = 8 [6%]) melanoma. Overall, the mean patient age at presentation was 7 years (median, 8; range, 1-12 years), with 63 males (49%). The mean age by tumor site was 6.50 ± 3.90, 7.44 ± 3.57, 9.12 ± 2.61, and 5.63 ± 2.38 years, for choroid/ciliary body, iris, conjunctiva, and eyelid melanoma, respectively (P = 0.001). Association with ocular melanocytosis was seen in 15%, 11%, 4%, and 0%, respectively (P = 0.01). Frequency of ocular melanoma family history did not vary by tumor site (7%, 17%, 9% and 12%, resp. [P = 0.26]). After mean follow-up of 74, 85, 50, and 105 months (P = 0.65), metastasis was seen in 12%, 9%, 19%, and 13% of choroid/ciliary body, iris, conjunctiva, and eyelid melanoma, respectively. Death was reported in 5%, 3%, 8%, and 0%, respectively, with survival analysis indicating higher mortality in choroidal/ciliary body and conjunctival melanoma patients.
    Ocular melanoma in the pediatric population is rare, with unique clinical features and outcomes. Iris melanoma accounts for about one-third of pediatric uveal melanoma cases.
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  • 文章类型: Journal Article
    目的:该研究的目的是描述在德国转诊诊所就诊的狗和猫的眼睑(LMCT)和结膜(CMCT)肥大细胞肿瘤的临床和组织学特征。
    方法:回顾了2006年至2020年诊断为LMCT或CMCT的狗和猫的医疗记录。
    结果:31例患者诊断为LMCT,分别为皮肤(n=28;20只狗和8只猫)或皮下(3只狗)。五例涉及皮肤粘膜交界处(四只狗,一只猫)。CMCT仅发生在狗中(n=3)。报告时,涉及皮肤粘膜交界处的四例犬LMCT病例中有两例已转移到下颌淋巴结。当应用Kiupel系统时,这两个病例都被归类为高等级。85.7%(18/21)的犬(19个皮肤和2个皮下)LMCT和所有CMCT病例被归类为Kiupel低等级。所有获得清洁手术切缘的LMCT病例均未出现局部复发(n=18,平均手术切缘宽度:犬9.4mm,猫3.8毫米)。两只猫(2/4)和四只狗(4/7)有可疑或不完整的手术切缘经历了局部复发(狗和猫的平均复发时间为180和637天,分别)。
    结论:低级别LMCT和CMCT切除后边缘清洁的复发很少见。涉及皮肤粘膜交界处的肿瘤可能级别更高,容易发生淋巴转移。
    OBJECTIVE: The objective of the study was to describe clinical and histologic characteristics of eyelid (LMCT) and conjunctival (CMCT) mast cell tumors in dogs and cats presented to a referral clinic in Germany.
    METHODS: Medical records were reviewed to identify dogs and cats diagnosed with LMCTs or CMCTs between 2006 and 2020.
    RESULTS: LMCT were diagnosed in 31 patients and were cutaneous (n = 28; 20 dogs and 8 cats) or subcutaneous (three dogs). Five cases involved the mucocutaneous junction (four dogs, one cat). CMCTs occurred only in dogs (n = 3). At the time of presentation two of the four canine LMCT cases involving the mucocutaneous junction had metastasized to a mandibular lymph node. When applying the Kiupel system, both these cases were categorized as high grade. 85.7% (18/21) of the canine (19 cutaneous and 2 subcutaneous) LMCT and all CMCT cases were categorized as Kiupel low grade. No local recurrences occurred in all LMCT cases in which clean surgical margins were obtained (n = 18, mean surgical margin width: dogs 9.4 mm, cats 3.8 mm). Two cats (2/4) and four dogs (4/7) with questionable or incomplete surgical margins experienced local recurrences (mean time to recurrence of 180 and 637 days in dogs and cats, respectively).
    CONCLUSIONS: Recurrence of low-grade LMCTs and CMCTs following excision with clean margins is rare. Tumors involving the mucocutaneous junction may be of higher grade and prone to lymphatic metastasis.
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  • 文章类型: Journal Article
    背景:已在眼睑皮脂腺癌(SGC)和鳞状细胞癌(SCC)中检测到人乳头瘤病毒(HPV),不同研究的检出率差异很大。本研究旨在探讨韩国人眼睑SGC和SCC中HPV的存在及其与临床病理特征的相关性。
    方法:从韩国三个转诊中心的病理学数据库中鉴定出1999年1月至2011年6月诊断为SGC或SCC的手术切除的眼睑样本。临床病理信息,包括起源(皮肤与骨结膜)和治疗结果进行回顾性审查。p16,HPVDNA原位杂交(ISH)的免疫组织化学(IHC),和基于聚合酶链反应的DNA微阵列在石蜡包埋的组织切片中进行。
    结果:我们的队列包括34例亚洲种族的SGC和12例SCC。通过DNA微阵列在4个SGC和6个SCC中检测到HPV,而2例SCC(16.7%)在ISH中显示阳性。与HPV阴性SCC相比,HPV阳性SCC明显更常见(6个中的5个与6的0,P=0.015,Fisher精确检验)。在p16IHC中显示阳性染色的样品中,SGC和SCCHPV阳性率分别为0.0%(0/19)和100%(3/3)。根据HPV状态,眼睑SGC和SCC的整体和局部复发率差异无统计学意义(P>0.99)。
    结论:HPV在韩国人的眼睑SGC和SCC的一个子集中发现,可能与tel骨结膜起源的SCC病因有关。p16的过表达被认为不适合作为眼睑SGC中HPV感染的指标。需要进一步研究以阐明HPV的传播途径和致病作用。
    BACKGROUND: Human papillomavirus (HPV) has been detected in eyelid sebaceous gland carcinoma (SGC) and squamous cell carcinoma (SCC), and detection rates greatly varied across studies. This study aimed to investigate the presence of HPV in eyelid SGC and SCC among Koreans and its correlation with clinicopathological characteristics.
    METHODS: Surgically resected eyelid samples diagnosed as SGC or SCC from January 1999 to June 2011 were identified from the pathology database of three referral centres in Korea. Clinicopathological information including origin (skin vs. tarsal conjunctiva) and treatment outcomes were retrospectively reviewed. Immunohistochemistry (IHC) for p16, HPV DNA in situ hybridisation (ISH), and polymerase chain reaction-based DNA microarray were performed in paraffin-embedded tissue sections.
    RESULTS: Our cohort included 34 SGC and 12 SCC cases with Asian ethnicity. HPV was detected in 4 SGC and 6 SCC by DNA microarray, while 2 SCC (16.7%) showed positivity in ISH. SCC of tarsal conjunctival origin was significantly more common in HPV-positive SCC than in HPV-negative SCC (5 of 6 vs. 0 of 6, P = 0.015, Fisher\'s exact test). Among samples showing positive staining in p16 IHC, HPV positivity rates were 0.0% (0/19) in SGC and 100% (3/3) in SCC. There was no significant difference in overall and local recurrence rate in eyelid SGC and SCC according to the HPV status (P > 0.99).
    CONCLUSIONS: HPV was found in a subset of eyelid SGC and SCC among Koreans and might be aetiologically related to SCC of tarsal conjunctival origin. Overexpression of p16 is considered to be inappropriate as an indicator of HPV infection in eyelid SGC. Further investigation is required to elucidate the transmission route and pathogenic roles of HPV.
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  • 文章类型: Journal Article
    目的:本研究旨在分析眼乳头状瘤的临床病理特征,一种常见的良性肿瘤,以及与复发和部分恶化相关的危险因素。
    方法:我们收集并分析了298例患者的临床资料(男性占51.68%),平均年龄为41.54±21.95岁,华西医院眼科。研究了可能与乳头状瘤复发和部分恶化有关的临床和病理因素。
    结果:前三个乳头状瘤部位是球结膜,眼睑皮肤和眼睑结膜。此外,3.59%的病变表现为恶变,16.28%的患者在平均4.47年的随访后出现一次或多次复发.多因素logistic回归模型显示多病灶是复发的危险因素(p=0.022,OR=3.088,95%CI:1.180~8.079),而冷冻治疗降低了复发风险(p=0.044,OR=0.364,95%CI:0.136-0.972)。此外,老年患者和角膜缘或角膜上的病变发生恶变的风险较高(p=0.004和0.01,OR=1.086和7.827,95%CI分别为1.027-1.150和1.629-37.596).
    结论:眼部乳头状瘤多发生于中青年患者,没有明显的性别差异。老年患者和角膜缘或角膜上的病变是部分恶变的危险因素。最后,多发性病变是复发的危险因素,冷冻疗法降低了复发率。
    OBJECTIVE: This study aimed to analyze the clinicopathological features of ocular papilloma, a common benign tumor, and the risk factors related to its recurrence and partial deterioration.
    METHODS: We collected and analyzed the clinical information of 298 patients (51.68% males) with mean age of 41.54 ± 21.95 years, in the ophthalmology department of the West China Hospital. Clinical and pathological factors that might be related to papilloma recurrence and partial deterioration were studied.
    RESULTS: The top three papilloma sites were bulbar conjunctiva, eyelid skin and palpebral conjunctiva. Moreover, 3.59% of lesions presented a malignant transformation, and 16.28% of patients had one or more recurrences after an average follow-up of 4.47 years. The multivariate logistic regression model showed that multiple lesions were a risk factor for recurrence (p = 0.022, OR = 3.088, 95% CI: 1.180-8.079), while cryotherapy decreased the recurrence risk (p = 0.044, OR = 0.364, 95% CI: 0.136-0.972). Additionally, elderly patients and lesions on the corneal limbus or cornea had a higher risk of malignant transformation (p = 0.004 and 0.01, OR = 1.086 and 7.827, 95% CI: 1.027-1.150 and 1.629-37.596, respectively).
    CONCLUSIONS: Ocular papilloma usually occurs in middle-aged and young patients, with no significant gender differences. Older patients and lesions on the corneal limbus or cornea are risk factors for partial malignant transformation. Finally, multiple lesions were a risk factor for recurrence, and cryotherapy reduced the recurrence rate.
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  • 文章类型: Journal Article
    背景:探讨眼睑恶性肿瘤患者行广泛局部切除术的临床病理特征与预后的相关性。
    方法:回顾性研究纳入2010年1月至2015年12月山西省眼科医院收治的141例眼睑恶性肿瘤患者。收集人口统计学和临床信息。Kaplan-Meier方法用于计算生存曲线,并采用对数秩检验方法比较各组之间的生存率。Cox比例回归模型用于计算总复发率和转移率的风险比(HR)。
    结果:总体而言,141例眼睑恶性肿瘤,年龄65.34±9.69(范围,41-88)岁。持续时间为1~828(61.09±122.21)个月。基底细胞癌(BCC)是所有眼睑恶性肿瘤中最常见的,占84(59.5%),其次是皮脂腺癌(SGC,41,29%),鳞状细胞癌(SCC,11,7.8%),恶性黑色素瘤(MM,3,2.1%)。关于cox回归分析,病理分类(HR1.959;95%CI1.012-3.790;p=0.046)和眼睑肿瘤手术史(HR17.168;95%CI1.889-156.011;p=0.012)与眼睑恶性肿瘤患者的复发独立相关。病理分类(HR2.177;95%CI1.423-3.331;p<0.001)与眼睑恶性肿瘤患者的转移独立相关。复发和转移最可能发生在术后3年。
    结论:广泛局部切除是治疗眼睑恶性肿瘤的一种有效、经济的方法。预后主要与病理类型有关,眼睑肿瘤手术史和TNM分期。
    BACKGROUND: To investigate the correlation between the clinical and pathological characteristics and outcomes in patients with eyelid malignant tumors underwent wide local excision.
    METHODS: This retrospective study included 141 cases of eyelid malignant neoplasms from January 2010 to December 2015 in Shanxi eye hospital. Demographic and clinical information were collected. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. Cox proportional regression models were used to calculate the hazard ratios (HR) of total recurrence rate and metastasis rate.
    RESULTS: Overall, there were 141 eyelid malignant neoplasms cases aged 65.34 ± 9.69 (range, 41-88) years old. The duration time range was from 1 to 828 (61.09 ± 122.21) months. Basal cell carcinoma (BCC) is the most common of all eyelid malignancies, accounting for 84 (59.5%), followed by Sebaceous gland carcinoma (SGC, 41, 29%), Squamous Cell Carcinoma (SCC, 11, 7.8%), Malignant Melanoma (MM, 3, 2.1%)。On cox-regression analysis, pathological classification (HR 1.959; 95% CI 1.012-3.790; p = 0.046) and eyelid tumor surgery history (HR 17.168; 95% CI 1.889-156.011; p = 0.012) were independently associated with recurrence in patients with eyelid malignant neoplasm. Pathological classification (HR 2.177; 95% CI 1.423 -3.331; p < 0.001) was independently associated with metastasis in patients with eyelid malignant neoplasm. Recurrence and metastasis were most likely to occur in 3 years after surgery.
    CONCLUSIONS: Wide local excision is an effective and economical treatment for eyelid malignant neoplasms. The prognosis is mainly related to pathological types, eyelid tumor surgical history and TNM stages.
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  • 文章类型: English Abstract
    Eyelid tumors are the most common neoplasms in everyday ophthalmic practice and cover a wide range of benign and malignant lesions. Surgical methods, cryodestruction, laser therapy and radiation therapy are used in the treatment of malignant eyelid tumors. Chemotherapy does not occupy a prominent place in the treatment of malignant eyelid tumors, its use is limited to sensitive tumors.
    To assess the antitumor activity of the Russian-developed chemical compound 2-[3-(2-chloroethyl)-3-nitrosoureido]-1.3-propandiol (chlonisol) on the models of transplantable tumors of various histogenesis implanted into the lower eyelid.
    The study was carried out on 67 mice of lines 129/SN, BALB/c and C57BL/6 that had Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1 and B16 melanoma transplanted into the eyelid. Tumor transplantation was done by injecting 0.05 ml of sterile sodium chloride solution containing 106 cells of Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1, or 10% suspension of tumor tissue of B16 melanoma. The injection was performed into the right lower eyelid in the direction from the outer towards the inner corner of the eye using a thin needle (29G). Chlonisol was administered at the maximum tolerated dose of 20 mg/kg or at the lower dose of 15 mg/kg intraperitoneally 24 hours after tumor transplantation.
    In mice with Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1 and melanoma B16 transplanted under the skin of the lower eyelid, a single intraperitoneal injection of chlonisol at the dose of 20 or 15 mg/kg caused significant inhibition of tumor growth reaching 100%. Chlonisol significantly increased overall survival in animals with Ehrlich carcinoma (log rank test, p=0.0464), sarcoma 37 (log rank test, p<0.0001), lymphosarcoma LIO-1 (log rank test, p=0.0122) and B16 melanoma (log rank test, p<0.0001); the proportion of animals that were fully healed was 25, 78, 67 and 25%, respectively.
    Chlonisol has a pronounced antitumor effect in mice with Ehrlich carcinoma, sarcoma 37, lymphosarcoma LIO-1 and B16 melanoma transplanted into the eyelid.
    Опухоли век являются наиболее распространенными новообразованиями в повседневной офтальмологической практике и охватывают широкий спектр доброкачественных и злокачественных новообразований. В лечении злокачественных опухолей век используют хирургический способ, криодеструкцию, лазеротерапию, лучевую терапию. Химиотерапия не занимает видного места в лечении злокачественных опухолей век, ее использование ограничивается чувствительными опухолями.
    Изучить влияние отечественного противоопухолевого соединения 2-[3-(2-хлорэтил)-3-нитрозоуреидо]-1,3-пропандиол (хлонизол) на рост перевиваемых опухолей различного гистогенеза, трансплантированных в нижнее веко.
    Исследование проведено на 67 мышах линий 129/SN, BALB/c и C57BL/6 с трансплантированными под кожу нижнего века карциномой Эрлиха, саркомой 37, лимфосаркомой ЛИО-1 и меланомой В16. Опухоль перевивали посредством инъекции 0,05 мл стерильного раствора натрия хлорида, содержащего 106 клеток карциномы Эрлиха, саркомы 37, лимфосаркомы ЛИО-1 или 10% взвеси опухолевой ткани меланомы B16. Инъекция производилась в нижнее правое веко в направлении от наружного к внутреннему углу глаза тонкой иглой (29G). Хлонизол вводили в максимально переносимой дозе (20 мг/кг) или в меньшей дозе (15 мг/кг) внутрибрюшинно через 24 ч после трансплантации опухоли.
    У мышей с трансплантированными под кожу нижнего века карциномой Эрлиха, саркомой 37, лимфосаркомой ЛИО-1 и меланомой В16 однократное внутрибрюшинное введение хлонизола в дозе 20 мг/кг или 15 мг/кг вызывало торможение роста опухоли, достигавшее 100%. Хлонизол значимо увеличивал общую выживаемость животных с карциномой Эрлиха (логранговый тест, p=0,0464), саркомой 37 (логранговый тест, p<0,0001), лимфосаркомой ЛИО-1 (логранговый тест, p=0,0122) и меланомой B16 (логранговый тест, p<0,0001); частота случаев полного излечения составила 25%, 78%, 67% и 25% соответственно.
    Хлонизол обладает выраженным противоопухолевым эффектом при трансплантированных в веко карциноме Эрлиха, саркоме 37, лимфосаркоме ЛИО-1 и меланоме В16.
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