Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Epidemiol Glob Health. 2022 Mar;12(1):25-39. doi: 10.1007/s44197-021-00017-1. Epub 2021 Nov 30.
Conjunctival lesions are common with a wide spectrum of benign, premalignant, and malignant lesions. Few histopathological studies have been conducted on conjunctival lesions with variable designs and results. Our aim in this study is to provide information on common conjunctival lesions seen in an ophthalmology tertiary care center in Saudi Arabia.
A retrospective, observational study of all consecutive conjunctival tissue specimens sent for histopathological assessment to the pathology department from 2015 to 2019 were analyzed. Clinical data were collected from medical records, and the histopathological slides were reviewed by a single pathologist.
A total of 110 conjunctival specimens from 108 patients were included (mean age: 53 years, 67 males and 43 females). Bilateral involvement was mostly found in inflammatory lesions (40%). Most lesions were benign (91%), with a significantly longer duration of symptoms in malignant lesions (p = 0.036*). The clinical diagnosis matched the final histopathological diagnosis in 75.5% of the total specimens. The most frequent category of benign lesions was fibrodegenerative and proliferative lesions (53.6%), with a significantly higher prevalence among adult males (p < 0.001). Melanocytic lesions were more common in children (33.3%) than adults (9.8%), and the mean age of children was significantly lower (p = 0.013). The most frequent malignant lesion was ocular surface squamous neoplasia (50%), with equal prevalence among males and females. The overall outcome was favorable in 89.4% and unfavorable in 10.6%, mostly due to surgical complications, further progression of the lesion, or recurrence.
This study shows variability in the frequency of conjunctival lesions based on gender, age, geographical, racial, and environmental factors. There has been a shift in the gender-based prevalence of ocular squamous neoplasia over the last three decades, probably due to a change in lifestyle.
结膜病变较为常见，其病变谱涵盖良性、癌前病变和恶性病变。少数关于结膜病变的组织病理学研究存在设计和结果的差异。本研究旨在为沙特阿拉伯一家眼科三级护理中心常见的结膜病变提供信息。
对 2015 年至 2019 年间病理科送检的所有连续结膜组织标本进行回顾性、观察性研究。临床数据从病历中收集，由一名病理学家对组织病理切片进行复查。
共纳入 108 例 110 份结膜标本（平均年龄：53 岁，男 67 例，女 43 例）。炎症性病变多为双侧受累（40%）。大多数病变为良性（91%），恶性病变的症状持续时间明显更长（p=0.036*）。在总标本中，临床诊断与最终组织病理学诊断相符的比例为 75.5%。良性病变中最常见的类别是纤维变性和增生性病变（53.6%），成年男性的发病率明显更高（p<0.001）。儿童中黑色素细胞病变（33.3%）比成人（9.8%）更常见，儿童的平均年龄明显更低（p=0.013）。最常见的恶性病变是眼表面鳞状细胞肿瘤（50%），男女性别患病率相等。总体预后良好率为 89.4%，预后不良率为 10.6%，主要与手术并发症、病变进一步进展或复发有关。
本研究显示结膜病变的频率因性别、年龄、地理位置、种族和环境因素而存在差异。在过去三十年中，眼鳞状细胞肿瘤的性别患病率发生了变化，可能与生活方式的改变有关。
