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目的分析、总结11例鼻咽癌(NPC)眼眶转移患者的临床特点和预后。方法回顾性分析1991至2003年间在中山大学中山眼科中心进行诊治的11例NPC眼眶转移患者的一般情况、临床表现、影像学检查、病理检查、治疗及随访情况。结果11例患者中男性9例,女性2例;平均年龄45.5岁;发生左眼眶转移10例,右眼眶转移1例。有明确NPC病史7例,无NPC病史4例;自NPC确诊至出现眼部症状平均12.7个月(2.0~60.0个月);就诊时眼部症状平均持续10.3个月(0.7~36.0个月)。眼眶有1处转移灶9例,2处转移灶2例;肿物主体位于眶鼻侧8例,颞侧2例,眶尖处1例,位于眶前部8例。手术将肿物全部取出或部分切除并送病理检查,结果提示鳞癌4例,淋巴上皮癌2例,未分化型5例。5例患者死于NPC远处转移,自确诊NPC眼眶转移至死亡间隔时间平均21个月;1例死因及存活时间不明;3例仍存活,未发现活动性病灶并继续接受治疗;2例失访。结论NPC眼眶转移临床很少见,但于中山眼科中心就诊的眼眶转移癌患者中原发于NPC者所占比例最高。转移病灶多数位于眼眶前部及鼻侧。患者预后较差。
Objective To analyze and summarize the clinical features and prognosis of 11 patients with nasopharyngeal carcinoma (NPC) orbital metastasis. Methods The clinical features, imaging findings, pathological findings, treatment and follow-up of 11 NPC patients with orbital metastasis who were diagnosed and treated at Zhongshan Eye Center of Sun Yat-sen University from 1991 to 2003 were analyzed retrospectively. Results There were 9 males and 2 females in 11 cases. The average age was 45.5 years. There were 10 left orbital metastases and 1 right orbital metastasis. There were 7 cases with definite NPC history and 4 cases without NPC history. The average eye symptom was 12.7 months (2.0 ~ 60.0 months) after diagnosis from the NPC. The ocular symptoms at the time of treatment averaged 10.3 months (0.7 ~ 36.0 months) . Orbital there is a metastasis in 9 cases, 2 cases of 2 cases of metastases; tumor main body located in 8 cases of orbital nose, temporal, 2 cases, 1 orbital apex, located in the anterior orbit in 8 cases. Surgical removal of all the tumor or partial removal and sent to pathological examination, the results suggest that 4 cases of squamous cell carcinoma, lymphoblastic carcinoma in 2 cases, undifferentiated in 5 cases. Five patients died of NPC distant metastasis, from the diagnosis of orbital NPC to death interval averaged 21 months; 1 case of death and survival time unknown; 3 cases still alive, no active lesions and continue treatment; 2 cases of loss visit. Conclusions There are few clinical cases of orbital metastasis of NPC, but the highest proportion of primary orbital metastases in Zhongshan Eye Center is the highest. The majority of metastatic lesions located in the anterior and nasal orbital. Patients with poor prognosis.