Kabra Ruchi C, Khaitan Isha A
Assistant Professor, Department of Ophthalmology, M & J Western Regional Institute of Ophthalmology, BJ Medical College, Civil Hospital , Ahmedabad, Gujrat, India .
Resident Doctor, Department of Ophthalmology, M & J Western Regional Institute of Ophthalmology, BJ Medical College, Civil Hospital , Ahmedabad, Gujrat, India .
J Clin Diagn Res. 2015 May;9(5):NC01-3. doi: 10.7860/JCDR/2015/13236.5932. Epub 2015 May 1.
Ocular surface squamous neoplasia (OSSN) refers to a spectrum of conjunctival and corneal epithelial disease ranging from dysplasia to invasive carcinoma. HIV infection is an important risk factor postulated for the development of disease.
To compare and to find out any statistically significant difference in patient demographics, clinical features and pathological findings in HIV infected and non-HIV infected histologically proven cases of ocular surface squamous neoplasia (OSSN).
In the present retrospective case study, data from indoor case records and ocular pathology records of histologically proven cases of OSSN was obtained. The data was then tabulated under various clinicopathological headings in HIV affected and non HIV affected groups. A chi-square test was applied to compare data of two groups and look for any significant difference between two groups. A p-value less than 0.05 was considered significant.
Amongst the total of 48 patients, 11 were HIV positive and 37 were HIV negative. Age of the patients ranged from 14-66 years in HIV and 22-66 years in non HIV group with a preponderance of younger age patients in HIV positive group. 54.5% patients with lesion having base more than 5mm were observed at the time of presentation in HIV positive population as compared to 21.6% in non HIV cases. Feeder vessels were seen in all HIV patients and a significantly greater degree of fornicial involvement was noted in comparison with non-HIV group. Histopathological analysis showed 63.63% of cases to be of invasive carcinoma amongst the HIV positive group and 54.05% of invasive carcinoma in non HIV group.
Younger age and aggressive looking tumour at presentation should caution ophthalmologist to look for an undiagnosed HIV infection in OSSN patients.
眼表鳞状上皮病变(OSSN)是指一系列从发育异常到浸润性癌的结膜和角膜上皮疾病。HIV感染是推测的该疾病发生的一个重要危险因素。
比较经组织学证实的HIV感染和未感染的眼表鳞状上皮病变(OSSN)患者在人口统计学、临床特征和病理结果方面的差异,并找出其中具有统计学意义的差异。
在本回顾性病例研究中,获取了经组织学证实的OSSN患者的住院病历和眼部病理记录数据。然后将这些数据按照不同的临床病理标题,分别列入HIV感染组和未感染组。应用卡方检验来比较两组数据,并寻找两组之间的任何显著差异。p值小于0.05被认为具有显著性。
在总共48例患者中,11例为HIV阳性,37例为HIV阴性。HIV组患者年龄在14 - 66岁之间,非HIV组患者年龄在22 - 66岁之间,HIV阳性组中年轻患者居多。HIV阳性人群中,54.5%的患者在就诊时病变基底超过5mm,而非HIV病例中这一比例为21.6%。所有HIV患者均可见供血血管,与非HIV组相比,穹窿部受累程度明显更高。组织病理学分析显示,HIV阳性组中63.63%的病例为浸润性癌,非HIV组中浸润性癌的比例为54.05%。
年龄较轻且就诊时肿瘤外观侵袭性较强,应提醒眼科医生在OSSN患者中留意未被诊断出的HIV感染。