眼部乳头状瘤的诊疗及预后现状

Diagnosis, treatment and prognosis of ocular papilloma

摘要:

眼部鳞状细胞乳头状瘤普遍被认为是一种常见的与人乳头瘤病毒(HPV)感染、紫外线照射等因素密切相关的眼部良性肿瘤，但是其病因尚未明确。病变往往表现为菜花或海绵状的灰白或肉粉色肿物，可见于结膜、泪阜、角膜缘、眼睑皮肤及眼眶等部位，采用前节高分辨率光学相干断层扫描(HR-OCT)、超声生物显微镜(UBM)等检查手段结合术后病理检查可以确诊。该疾病有一定的复发倾向，一些学者认为生长部位、细胞异型性、治疗方式等可能是影响疾病复发的因素。目前临床治疗以手术切除为主，部分加以术中冷冻、羊膜移植、丝裂霉素(MMC)、干扰素α-2b(IFN α-2b)、5-氟尿嘧啶(5-FU)等辅助治疗方法，有研究发现合理规范的辅助治疗对于减少复发有一定作用，但仍需要进一步的大样本研究证实。

Abstract:

Ocular squamous cell papilloma is a common benign ocular tumor which has been associated with human papillomavirus(HPV)infection, ultraviolet(UV)radiation exposure, etc., but the pathogenesis still remains uncertain. The tumor often shows a fleshy or gray-white mass with a cauliflowerlike or spongylike appearance involving the conjunctiva, caruncle, limbus, eyelid or orbit. It can be diagnosed by combined examinations including high-resolution optical coherence tomography(HR-OCT), ultrasound biological microscope(UBM)and histopathological examination. Risk factors for local recurrence of ocular squamous cell papilloma may include location of the tumor, cellular atypia and ways of treatment. Surgery has historically been the mainstay of treatment. In addition, adjunctive therapies including cryotherapy, amniotic membrane transplantation, mitomycin(MMC), interferon α-2b(IFN α-2b)or 5-fluorouracil(5-FU)may also help to improve the local control. However, more studies are still needed to prove the effects of adjuvant therapy to surgery in ocular squamous cell papilloma.