Clinical Department, Mzuzu Central Hospital, Mzuzu, Malawi
Biological Sciences, Mzuzu University, Mzuzu, Malawi.
BMJ Open Ophthalmol. 2022 Mar 23;7(1):e000977. doi: 10.1136/bmjophth-2022-000977. eCollection 2022.
Orbito-ocular cancers are a common cause of morbidity and mortality in our population, yet these cancers have not been adequately described in Malawi. This study sought to describe the burden and histopathological profile of orbito-ocular cancers in Northern Malawi.
A retrospective review of pathology reports was done. Descriptive analyses were performed to summarise patients' demographic and clinical characteristics, and histopathological results. A binary logistic regression was used to explore the association between demographic variables, site of lesion and cancer.
210 pathology reports of orbito-ocular biopsies were reviewed. 60.0% of patients were female. The majority (39.5%) of patients were in the 31 to 40 age group but overall mean age (±SD) was 34.81±15.9 years. Cancer was diagnosed in 84 (40.0%) patients. Squamous cell carcinoma constituted the majority (82.1%) of cancers followed by retinoblastoma at 7.1%. Orbito-ocular cancers were associated with HIV infection (OR5.9, 95% CI 2.0 to 17.2) and intraocular tumours were 8.3 times (OR 8.3, 95% CI 2.0 to 33.8) more likely to be malignant. However, squamous cell carcinoma was the only type of cancer found in patients with HIV infection and mostly affected the conjunctiva, constituting 94.4% of cancers affecting this site. Retinoblastoma on the other hand only affected children less than 10 years of age.
Cancer constituted a substantial proportion of orbito-ocular lesions in our study population, with conjunctiva being the common site. This calls for improved capacity to prevent, diagnose and manage orbito-oracular cancers in Northern Malawi and similar settings.
眼窝-眼部癌症是我们人群中发病率和死亡率的一个常见原因,但在马拉维,这些癌症尚未得到充分描述。本研究旨在描述马拉维北部眼窝-眼部癌症的负担和组织病理学特征。
对病理报告进行了回顾性审查。采用描述性分析总结患者的人口统计学和临床特征以及组织病理学结果。采用二元逻辑回归探索人口统计学变量、病变部位和癌症之间的关联。
共审查了 210 份眼窝-眼部活检的病理报告。60.0%的患者为女性。大多数(39.5%)患者年龄在 31 至 40 岁之间,但总体平均年龄(±SD)为 34.81±15.9 岁。84 名(40.0%)患者被诊断患有癌症。鳞状细胞癌构成了大多数(82.1%)癌症,其次是视网膜母细胞瘤,占 7.1%。眼窝-眼部癌症与 HIV 感染相关(OR5.9,95%CI 2.0 至 17.2),眼内肿瘤恶性的可能性是 8.3 倍(OR 8.3,95%CI 2.0 至 33.8)。然而,鳞状细胞癌是 HIV 感染患者中唯一发现的癌症类型,主要影响结膜,构成了影响该部位的 94.4%的癌症。另一方面,视网膜母细胞瘤仅影响 10 岁以下的儿童。
在我们的研究人群中,癌症构成了眼窝-眼部病变的相当大一部分,结膜是常见的部位。这需要在马拉维北部和类似环境中提高预防、诊断和管理眼窝-眼部癌症的能力。