Frucht-Pery J, Sugar J, Baum J, Sutphin J E, Pe'er J, Savir H, Holland E J, Meisler D M, Foster J A, Folberg R, Rozenman Y
Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel.
Ophthalmology. 1997 Dec;104(12):2085-93. doi: 10.1016/s0161-6420(97)30055-4.
The purpose of the study is to evaluate the efficacy and risks of topical mitomycin C (MMC) for conjunctival-corneal intraepithelial neoplasia (CCIN).
The study design was a clinical case series of CCIN.
Seventeen patients, 16 with biopsy-confirmed CCIN and 1 with invasive squamous cell carcinoma (SCC), were included in the study.
Patients received topical drops of MMC 0.02% to 0.04% four times daily from 7 to 28 days. Retreatment was done in cases of lesion recurrence.
The size of the CCIN before and after the treatment and ocular complications post-MMC application were evaluated.
Ten patients remained disease-free after one course of MMC application. In one case, residual CCIN remained very small without regrowth. In the one patient with invasive SCC and in five patients with CCIN, regrowth occurred within 6 months of the first treatment. After retreatment, invasive SCC and CCIN in an additional two patients were eradicated. In two cases, although the size of the lesions decreased after two and three applications of MMC, regrowth occurred, and the CCIN returned to its original size. In the final case, limited recurrence has occurred and no retreatment has been done. The complications of MMC use included mild-to-moderate conjunctival hyperemia and mild allergy, which resolved after discontinuation of the treatment. Severe pain manifested when treatment was longer than 14 days.
Application of topical MMC is an efficient treatment for most but not all cases of CCIN.
本研究旨在评估局部应用丝裂霉素C（MMC）治疗结膜角膜上皮内瘤（CCIN）的疗效和风险。
本研究设计为CCIN的临床病例系列。
17例患者纳入研究，其中16例经活检确诊为CCIN，1例为浸润性鳞状细胞癌（SCC）。
患者每天4次局部滴用0.02%至0.04%的MMC，持续7至28天。病变复发时进行再次治疗。
评估治疗前后CCIN的大小以及MMC应用后的眼部并发症。
10例患者在一个疗程的MMC应用后疾病无复发。1例患者残留的CCIN非常小，未再生长。1例浸润性SCC患者和5例CCIN患者在首次治疗后6个月内出现复发。再次治疗后，另外2例患者的浸润性SCC和CCIN被根除。2例患者尽管在2次和3次应用MMC后病变大小减小，但仍出现复发，CCIN恢复到原来大小。最后1例患者出现有限复发，未进行再次治疗。MMC使用的并发症包括轻度至中度结膜充血和轻度过敏，治疗中断后症状缓解。治疗超过14天时出现严重疼痛。
局部应用MMC对大多数但并非所有CCIN病例都是一种有效的治疗方法。
