UC Davis Eye Center, University of California, Davis, Sacramento, CA; and.
California Northstate University College of Medicine, Elk Grove, CA.
Cornea. 2022 Feb 1;41(2):149-154. doi: 10.1097/ICO.0000000000002780.
The aim of this study was to evaluate the prevalence of histopathologically confirmed ocular surface squamous neoplasia (OSSN) in clinically diagnosed pterygium samples at a tertiary center in Northern California, over a 10-year period (2009-2019).
A retrospective chart review of patients older than 18 years with clinically diagnosed benign pterygium requiring excision was conducted. Clinically suspected pterygia were excised using standard techniques and routinely submitted to the University of California Davis for pathologic evaluation. Demographic, clinical, surgical, and pathological information were recorded and analyzed. The prevalence rate of OSSN was calculated.
A total of 348 consecutive specimens were evaluated. The mean (±SD) age of the patients was 58 ± 12 years, with a near equal sex representation. A total of 57 (16%) pterygia were recurrent at initial presentation. Histopathologic results demonstrated a single case of OSSN. This patient did not have a documented history of carcinoma in other organs or any history of herpes virus, human papilloma virus, or human immunodeficiency virus infection.
The prevalence of histopathological OSSN in clinically suspected pterygia within our sample was approximately 0.3%. Because of shared clinical characteristics of pterygia and OSSN, a high index of suspicion and judicious use of anterior segment optical coherence tomography enable for effective preoperative diagnosis of OSSN. However, in the absence of clinical expertise or high-resolution optical coherence tomography, routine tissue pathologic examination may be warranted.
本研究旨在评估在加利福尼亚北部的一家三级中心，经过 10 年（2009-2019 年）的时间，临床上诊断为翼状胬肉的样本中组织病理学确诊的眼表鳞状上皮肿瘤（OSSN）的发生率。
对 348 例年龄大于 18 岁且患有需切除的临床诊断为良性翼状胬肉的患者进行了回顾性图表审查。采用标准技术切除临床上疑似的翼状胬肉，并常规提交给加利福尼亚大学戴维斯分校进行病理评估。记录和分析了人口统计学、临床、手术和病理信息。计算了 OSSN 的患病率。
共评估了 348 个连续标本。患者的平均（±SD）年龄为 58 ± 12 岁，性别比例几乎相等。初次就诊时，共有 57 例（16%）翼状胬肉复发。组织病理学结果显示仅有 1 例 OSSN。该患者没有其他器官癌的病史记录，也没有疱疹病毒、人乳头瘤病毒或人类免疫缺陷病毒感染的病史。
在我们的样本中，临床上疑似翼状胬肉的组织病理学 OSSN 的患病率约为 0.3%。由于翼状胬肉和 OSSN 具有共同的临床特征，因此高度怀疑并明智地使用前节光学相干断层扫描可以有效地对 OSSN 进行术前诊断。但是，如果没有临床专业知识或高分辨率光学相干断层扫描，则可能需要常规组织病理学检查。
