Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Ophthalmology. 2011 Nov;118(11):2133-2137.e1. doi: 10.1016/j.ophtha.2011.04.001. Epub 2011 Jul 16.
To describe the relationship between chronic systemic immune suppression and conjunctival squamous cell carcinoma (SCC).
Retrospective interventional case series.
Thirteen immunosuppressed patients with conjunctival SCC.
Surgical excision in all cases plus additional topical interferon alpha-2B or mitomycin.
Tumor control.
There were 3 groups of patients with chronic immunosuppression and conjunctival SCC, including 8 patients who received an organ transplant, 4 patients with human immunodeficiency virus (HIV), and 1 patient with systemic lupus erythematosus (SLE) receiving long-term corticosteroids. The transplanted organ was kidney (n=4) (1 with additional pancreas transplant), lung (n=2), liver (n=1), and heart (n=1). The mean patient age at presentation for the organ transplant group was 60 years, and the mean interval from transplant to conjunctival SCC was 8.2 years. Management included surgical excision (n=8) plus additional topical interferon alpha-2B (n=3) and mitomycin C (n=1). Three patients showed aggressive recurrence or new tumor, and 1 patient died of brain invasion of SCC. In the HIV group, the mean patient age at presentation was 54 years and the mean interval from HIV diagnosis to conjunctival SCC was 5 years. Management included surgical excision (n=5) plus additional topical interferon alpha-2B (n=3) and mitomycin C (n=1). One patient showed aggressive extensive recurrence requiring enucleation and radiotherapy, and there were no related deaths. The patient with SLE was 49 years old, had been taking systemic corticosteroids for 18 years, and showed control with surgical resection and topical interferon alpha-2B. Of the 5 patients treated with excision and prompt topical interferon alpha-2B, none showed recurrence or new tumor.
Conjunctival SCC can occur in immunosuppressed patients and can be more aggressive and invasive, requiring enucleation or exenteration. Surgical resection plus topical interferon alpha-2B might reduce the risk for recurrence or new tumor.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
描述慢性系统性免疫抑制与结膜鳞状细胞癌（SCC）之间的关系。
回顾性干预性病例系列。
13 例患有结膜 SCC 的免疫抑制患者。
所有病例均行手术切除，加用局部干扰素 α-2B 或丝裂霉素。
肿瘤控制。
有 3 组慢性免疫抑制合并结膜 SCC 患者，包括 8 例接受器官移植者、4 例人类免疫缺陷病毒（HIV）感染者和 1 例系统性红斑狼疮（SLE）长期接受皮质类固醇治疗者。移植器官为肾脏（n=4）（1 例加胰腺移植）、肺（n=2）、肝（n=1）和心脏（n=1）。器官移植组患者的平均发病年龄为 60 岁，从移植到结膜 SCC 的平均间隔为 8.2 年。治疗包括手术切除（n=8）加局部干扰素 α-2B（n=3）和丝裂霉素 C（n=1）。3 例患者表现为侵袭性复发或新发肿瘤，1 例患者因 SCC 脑侵犯而死亡。在 HIV 组中，患者的平均发病年龄为 54 岁，从 HIV 诊断到结膜 SCC 的平均间隔为 5 年。治疗包括手术切除（n=5）加局部干扰素 α-2B（n=3）和丝裂霉素 C（n=1）。1 例患者表现为侵袭性广泛复发，需要眼球摘除和放疗，无相关死亡。SLE 患者 49 岁，已接受全身皮质类固醇治疗 18 年，手术切除联合局部干扰素 α-2B 治疗后得到控制。5 例接受切除和及时局部干扰素 α-2B 治疗的患者均未出现复发或新发肿瘤。
结膜 SCC 可发生于免疫抑制患者，且侵袭性更强，需要眼球摘除或眼眶内容物剜除。手术切除加局部干扰素 α-2B 可能降低复发或新发肿瘤的风险。
作者没有与本文讨论的材料有关的专有或商业利益。
