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目的探讨手术切除联合液氮冷冻治疗结膜鳞状细胞癌的临床效果。方法分析1998年2008年收治的21例眼睑结膜鳞癌患者的临床资料。对肿瘤局限在眼球结膜和部分穹窿结膜受侵犯者行单纯手术切除联合液氮冷冻治疗;部分或全部结膜及眼睑受侵犯者行局部肿瘤切除联合眼睑重建及液氮冷冻治疗;眼睑和球结膜广泛受累,无法进行眼睑重建者行眼眶内容物剜除术。结果 21例中,7例行单纯肿瘤切除合并冷冻治疗,其中5例痊愈,2例复发;10例行局部肿瘤切除并进行眼睑重建,其中7例痊愈,3例复发,复发病例作眶内容摘除;4例肿瘤侵犯范围较宽而无法保留眼球者行眼眶内容物摘除。术手3例死于肝肺转移。结论眼睑结膜鳞状细胞瘤的外科手术切除是唯一有效的方法 ,眼睑重建视肿瘤侵犯范围而定,冷冻治疗作为辅助治疗可提高疾病的治愈率。
Objective To investigate the clinical effect of surgical resection combined with liquid nitrogen freezing in the treatment of conjunctival squamous cell carcinoma. Methods Clinical data of 21 patients with conjunctival squamous cell carcinoma of the eyelid treated in 1998 and 2008 were analyzed. The tumor is limited in the conjunctiva and partial fornix conjunctival invasion were treated with simple surgical resection combined with liquid nitrogen cryotherapy; partial or total conjunctiva and eyelid invasion of local tumor resection combined with eyelid reconstruction and liquid nitrogen cryotherapy; eyelid and conjunctiva widespread Involved, unable to reconstruct the eyelid orbital content excision. Results Of the 21 cases, 7 cases were treated with simple tumor resection combined with cryotherapy, of which 5 cases recovered and 2 cases relapsed; 10 cases underwent partial resection of the tumor and reconstruction of the eyelid, of which 7 cases recovered and 3 cases relapsed and recurred as orbital contents ; 4 cases of tumor invasion of a wide range of patients who can not keep the eye orbital content removal. 3 cases died of liver and lung metastases. Conclusions Surgical removal of conjunctival squamous cell tumor is the only effective method. Eyelid reconstruction depends on the extent of tumor invasion. Cryotherapy, as adjuvant therapy, can improve the cure rate of the disease.