Furdová A, Stopková A, Kapitánová K, Kobzová D, Babál P
Cesk Slov Oftalmol. 2018 Winter;74(3):92-97. doi: 10.31348/2018/1/2-3-2018.
The etiology of papilloma formation is multifactorial. There is a strong association between human papillomavirus (HPV) and the development of these conjunctival lesions. HPV is tumorigenic and commonly produces benign tumors with low malignant potential. Papillomas rarely go through malignant transformation.
Retrospective study of patients with a diagnosis of conjunctival papilloma or squamous cell carcinoma.
From a collection of 125 patients with conjunctival non-pigmented tumours in the period from 2007 to 2017, in 119 (95.2%) patients histological examination confirmed papilloma and in 6 (4.8%) patients it confirmed carcinoma. Of the total number of patients, 39 were women (31.2%) and 86 men (68.8%). The mean age of patients was 68.4 years (range 20-94 years). Localization of lesions: bulbar conjunctiva - 65 (52.0%), upper eyelid tarsal conjunctiva + fornix - 6 (4.8%), lower eyelid + fornix - 27 (21.6%), caruncle - 20 (16.0%) and plica semilunaris - 7 (5.6%) patients. In the patient cohort we recorded 2 papillomas that were transformed into squamous cell carcinoma. HPV16 was positive in these patients, the carcinomas were from the area of the bulbar conjunctiva, and the surgical solution was associated with the perioperative administration of Mitomycin C. In one case, the inverted papilloma developed into orbital carcinoma within 2 years of primary excision, and the patient underwent radical surgical procedure (partial exenteration of the orbit) followed by radiotherapy.
Transformation of the papilloma into the carcinoma is rare, but it must always be taken into consideration in case of a recurrence of the disease. HPV can infect the conjunctiva. The ophthalmologist, in collaboration with a pathologist, may recommend appropriate laboratory tests to confirm the diagnosis. Long-term outpatient follow-up of patients after excision of the conjunctival papilloma is also necessary. Key words: epibulbar tumors, conjunctival tumors, papilloma, carcinoma.
乳头状瘤形成的病因是多因素的。人乳头瘤病毒（HPV）与这些结膜病变的发生之间存在密切关联。HPV具有致瘤性，通常产生恶性潜能低的良性肿瘤。乳头状瘤很少发生恶性转化。
对诊断为结膜乳头状瘤或鳞状细胞癌的患者进行回顾性研究。
在2007年至2017年期间收集的125例结膜无色素肿瘤患者中，119例（95.2%）患者的组织学检查确诊为乳头状瘤，6例（4.8%）患者确诊为癌。在所有患者中，女性39例（31.2%），男性86例（68.8%）。患者的平均年龄为68.4岁（范围20 - 94岁）。病变部位：球结膜 - 65例（52.0%），上睑睑结膜 + 穹窿 - 6例（4.8%），下睑 + 穹窿 - 27例（21.6%），泪阜 - 20例（16.0%），半月皱襞 - 7例（5.6%）。在患者队列中，我们记录到2例乳头状瘤转化为鳞状细胞癌。这些患者的HPV16呈阳性，癌来自球结膜区域，手术方案与围手术期给予丝裂霉素C有关。1例患者，内翻乳头状瘤在初次切除后2年内发展为眼眶癌，患者接受了根治性手术（眼眶部分摘除术），随后进行了放疗。
乳头状瘤转化为癌很罕见，但在疾病复发时必须始终予以考虑。HPV可感染结膜。眼科医生与病理学家合作，可推荐适当的实验室检查以确诊。结膜乳头状瘤切除术后对患者进行长期门诊随访也很有必要。关键词：眼球表面肿瘤、结膜肿瘤、乳头状瘤、癌
