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目的 分析虹膜睫状体肿瘤患者的临床表现、鉴别诊断要点、病理组织学特征、处理及预后。方法 对 196 6年 1月至 2 0 0 0年 12月经病理检查证实的 37例虹膜睫状体肿瘤的临床和病理资料进行回顾性分析。结果 按病理组织学分类 ,第一位为虹膜睫状体黑色素瘤 15例 ( 40 5 % ) ,其他依次为虹膜睫状体转移癌 8例 ( 2 1 6 % )、睫状体髓上皮瘤 3例 ( 8 1% )、虹膜色素痣 2例 ( 5 4% )及其他 9例 ( 2 4 3% )。处理方法 :局部切除 14例 ( 37 8% ) ,眼球摘除 2 1例 ( 5 6 8% ) ,活检后观察 2例( 5 4% )。对其中的 34例随访 2个月至 15年 ,平均 31个月。虹膜睫状体黑色素瘤多呈半球形或球形的棕黑色实性肿物 ,肿瘤内有丰富的新生血管 ,部分睫状体黑色素瘤邻近的表层巩膜有“哨兵”样血管 ,巩膜透照试验瘤体不透光 ;超声生物显微镜检查示低至中等回声图像 ,邻近受累组织回声及形态异常 ,对黑色素瘤特异性抗原呈阳性反应 ,预后较好。虹膜睫状体转移癌可为单发或多发 ,肿瘤扁平隆起或近似球形 ,色泽污秽 ,有丰富的新生血管 ,生长迅速 ,可发现原发癌 ,预后极差。结论 虹膜睫状体黑色素瘤具有典型的临床特征 ,易与其他虹膜睫状体良、恶性肿瘤混淆。虹膜睫状体转移癌的临床表现复杂 ,需借助影像学检查及免疫组化?
Objective To analyze the clinical manifestations, differential diagnosis, histopathological features, treatment and prognosis of patients with iris and ciliary body tumors. Methods The clinical and pathological data of 37 cases of iris and ciliary body tumors confirmed by pathology from January 1996 to December 2000 were analyzed retrospectively. Results According to the histopathological classification, the first was 15 cases (40.5%) of the iris ciliary body melanoma, the other was iridociliary metastasis in 8 cases (21.6%), the ciliary body myeloma 3 (81%), two cases of iris nevi (54%) and the other nine cases (24.3%). Methods: 14 cases (37.8%) underwent partial excision, 21 cases (56.8%) underwent enucleation and 2 cases (54%) after biopsy. 34 of them were followed up for 2 months to 15 years with an average of 31 months. The iris ciliary body melanoma mostly hemispherical or spherical brown black solid tumor, the tumor is rich in neovascularization, some ciliary body melanoma adjacent scleral surface of the Sentinel-like blood vessels, scleral transillumination test tumor Body opacity; ultrasound biomicroscopy showed low to medium echo images, adjacent to the affected tissue echo and morphological abnormalities, positive for melanoma-specific antigen, the prognosis is good. Iridocarcinoma of the ciliary body metastasis can be single or multiple, flat tumor uplift or nearly spherical, color contamination, rich in neovascularization, rapid growth, primary cancer can be found, the prognosis is poor. Conclusion Iris ciliary body melanoma has typical clinical features and is easily confused with other iris and ciliary body benign and malignant tumors. The clinical manifestations of iridocyclocacinoma are complex and require imaging and immunohistochemistry.