Mittal Ruchi, Rath Suryasnata, Vemuganti Geeta Kashyap
Dalmia Ophthalmic Pathology Service, L.V. Prasad Eye Institute, Bhubaneswar, India.
Saudi J Ophthalmol. 2013 Jul;27(3):177-86. doi: 10.1016/j.sjopt.2013.07.002.
Ocular surface squamous neoplasia (OSSN) has a varied clinical presentation, the diagnosis of which rests on the histopathological examination of the excised lesion. The term OSSN includes mild dysplasia on one end of the spectrum and invasive squamous cell carcinoma on the other end. This lesion has a multi factorial aetiology with interplay of several factors like exposure to ultraviolet radiation, various chemical carcinogens and viral infections, however role of individual agents is not well understood. With the upsurge of infection with human immunodeficiency virus, a changing trend is seen in the clinical presentation and prognosis of patients of OSSN even in developed countries. Anterior segment optical coherence tomography (OCT) and confocal microscopy, hold promise in in-vivo differentiation of intraepithelial neoplasia from invasive squamous cell carcinoma. Variants of squamous cell carcinoma like Mucoepidermoid carcinoma, spindle cell carcinoma and OSSN associated with HIV infection should be suspected in a case of aggressive clinical presentation of OSSN or with massive and recurrent tumours. Surgery, chemotherapy and immunotherapy are the various treatment modalities which in combination show promising results in aggressive, recurrent and larger tumours.
眼表鳞状上皮肿瘤（OSSN）临床表现多样，其诊断依赖于对切除病变的组织病理学检查。OSSN这一术语涵盖了该病变谱系一端的轻度发育异常和另一端的浸润性鳞状细胞癌。此病变病因多因素，涉及多种因素相互作用，如紫外线辐射暴露、各种化学致癌物及病毒感染等，但各因素的具体作用尚不清楚。随着人类免疫缺陷病毒感染率上升，即使在发达国家，OSSN患者的临床表现和预后也出现了变化趋势。眼前节光学相干断层扫描（OCT）和共聚焦显微镜检查有望在体内鉴别上皮内瘤变与浸润性鳞状细胞癌。对于OSSN临床表现侵袭性强或出现巨大及复发性肿瘤的病例，应怀疑存在鳞状细胞癌的变异型，如黏液表皮样癌、梭形细胞癌以及与HIV感染相关联的OSSN。手术、化疗和免疫疗法是多种治疗方式，联合应用对侵袭性、复发性及较大肿瘤显示出有前景的治疗效果。
