眼前节光学相干断层扫描特征比较结膜乳头瘤与乳头瘤样眼表鳞状上皮瘤。
Anterior segment optical coherence tomography characteristics of conjunctival papilloma as compared to papilliform ocular surface squamous neoplasia.
机构信息
Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA.
Department of Ophthalmology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand.
出版信息
Eye (Lond). 2023 Apr;37(5):995-1001. doi: 10.1038/s41433-022-02309-7. Epub 2022 Nov 19.
PURPOSE
To describe the anterior segment optical coherence tomography (AS-OCT) appearance of conjunctival papilloma and identify differentiating features from papilliform ocular surface squamous neoplasia (OSSN).
METHOD
A retrospective chart review of individuals clinically diagnosed with conjunctival papilloma (n = 10) or papilliform OSSN (n = 10) based on slit lamp features. Data on demographics, tumour characteristics, and primary treatment were collected. AS-OCT features were assessed including epithelial thickness and reflectivity, a corrugated epithelial surface, presence of an overhanging edge, presence of intrinsic spaces and posterior shadowing. Histopathology was available in 5 papilloma and 3 OSSN specimens.
RESULT
Overall, the majority of individuals in both groups were white males. OSSN lesions were more likely to involve the limbus (80% vs.10%, p = 0.005) and the bulbar conjunctiva (100% vs. 20%, p < 0.001) compared to papillomas. On AS-OCT, maximum epithelial thickness was thicker in papilloma compared to OSSN (936 ± 533 vs. 637 ± 207 µm, p = 0.009). The feature that best differentiated papilloma from OSSN was an overhanging edge (100% vs. 0%, p < 0.001), where the epithelial lesion was seen on top of underlying normal epithelium. Other features more common in papilloma compared to OSSN included a corrugated epithelial surface (70% vs.10%, p = 0.02), the presence of intrinsic spaces (100% vs. 50%, p = 0.03), and posterior shadowing (100% vs. 40%, p = 0.01).
CONCLUSION
AS-OCT shows differentiating features between papilloma and OSSN with an overhanging edge as a distinctive AS-OCT feature of papilloma.
目的
描述结膜乳头瘤的眼前节光学相干断层扫描（AS-OCT）表现，并确定其与乳头样眼表鳞状上皮瘤（OSSN）的鉴别特征。
方法
回顾性分析基于裂隙灯特征临床诊断为结膜乳头瘤（n=10）或乳头样 OSSN（n=10）的患者的病历。收集人口统计学、肿瘤特征和主要治疗数据。评估 AS-OCT 特征，包括上皮厚度和反射率、上皮表面褶皱、悬垂边缘、固有空间和后部阴影。5 例乳头瘤和 3 例 OSSN 标本均有组织病理学检查。
结果
两组患者中，大多数为白人男性。与乳头瘤相比，OSSN 病变更可能累及角膜缘（80%比 10%，p=0.005）和球结膜（100%比 20%，p<0.001）。AS-OCT 检查中，乳头瘤的上皮最大厚度大于 OSSN（936±533 比 637±207μm，p=0.009）。能够将乳头瘤与 OSSN 区分开的最佳特征是悬垂边缘（100%比 0%，p<0.001），即上皮病变位于下方正常上皮之上。与 OSSN 相比，更常见于乳头瘤的其他特征包括上皮表面褶皱（70%比 10%，p=0.02）、固有空间（100%比 50%，p=0.03）和后部阴影（100%比 40%，p=0.01）。
结论
AS-OCT 显示了乳头瘤和 OSSN 之间的鉴别特征，悬垂边缘是乳头瘤的独特 AS-OCT 特征。
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