Meng X S, Liu X W
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhonghua Yan Ke Za Zhi. 2019 May 11;55(5):369-373. doi: 10.3760/cma.j.issn.0412-4081.2019.05.011.
To summarize and analyze the clinical manifestation of conjunctival papilloma, its relationship with human papillomavirus (HPV) infection and the recurrence after the combination of operation and pharmacotherapy. A retrospective case series study. Analysis of 40 patients (41 eyes) with conjunctival papilloma treated at Peking Union Medical College Hospital from January 2008 to June 2018 was performed. All patients were given routine blood and urine, hepatitis B virus surface antigen, antibodies to hepatitis C virus, antibodies to human immunodeficiency virus and antibodies to testing, and HPV testing for the urethra epithelial tissue. Direct contact of the tumor with instruments was avoided during surgery, and freezing treatment was combined. HPV testing was performed for the resected conjunctival papilloma. Multiple medications were used after surgery. In 40 cases with 41 eyes, there were 22 males (23 eyes) and 18 females (18 eyes). A single tumor was seen in 27 eyes, and multiple tumors were seen in 14 eyes. Thirteen patients (13 eyes) older than 50 years old had pedicel-free papillpma, and 27 patients (28 eyes) aged from 12 to 40 years had pedicel-type papillpma. All cases were confirmed by pathology as conjunctival papilloma, of which 9 cases showed moderate to severe atypical hyperplasia on squamous cells. The HPV test was positive in 17 out of the 40 cases (42.5%) of conjunctival papilloma. Urine test results of 16 patients (40.0%) were positive for occult blood and showed that urinary white blood cell was elevated. Of the 40 patients, 33 were newly diagnosed and 7 had a relapse. The average follow-up time was (37.4±11.9) months after combined therapy and no recurrence was found in any patients. Conjunctival papilloma is usually observed in people aged from 20 to 40 years and older than 50 years, and it often occurs in one eye. Its main pathological feature is benign tumors of the papillary hyperplasia on the conjunctival epithelial tissue. Some patients have atypical hyperplasia of squamous cells. The cause of the disease may be related to the infection of HPV and the urinary tract. Combined treatment can reduce the recurrence rate of conjunctival papilloma. .
总结分析结膜乳头状瘤的临床表现、与人乳头瘤病毒(HPV)感染的关系以及手术联合药物治疗后的复发情况。进行一项回顾性病例系列研究。对2008年1月至2018年6月在北京协和医院接受治疗的40例(41眼)结膜乳头状瘤患者进行分析。所有患者均进行了血常规、尿常规、乙肝表面抗原、丙肝抗体、艾滋病毒抗体检测以及尿道上皮组织的HPV检测。手术过程中避免肿瘤与器械直接接触,并联合冷冻治疗。对切除的结膜乳头状瘤进行HPV检测。术后使用多种药物。40例41眼中,男性22例(23眼),女性18例(18眼)。单发性肿瘤27眼,多发性肿瘤14眼。13例(13眼)年龄大于50岁的患者为无蒂乳头状瘤,27例(28眼)年龄在12至40岁的患者为有蒂乳头状瘤。所有病例经病理确诊为结膜乳头状瘤,其中9例鳞状细胞呈中度至重度非典型增生。40例结膜乳头状瘤患者中17例(42.5%)HPV检测呈阳性。16例患者(40.0%)尿常规潜血阳性,尿白细胞升高。40例患者中,33例为初诊,7例复发。联合治疗后平均随访时间为(37.4±11.9)个月,所有患者均未复发。结膜乳头状瘤常见于20至40岁以及50岁以上人群,常单眼发病。其主要病理特征为结膜上皮组织乳头样增生的良性肿瘤。部分患者有鳞状细胞非典型增生。发病原因可能与HPV感染及泌尿系统有关。联合治疗可降低结膜乳头状瘤的复发率。