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目的评价局部滴用0.04%丝裂霉毒C(MMC)眼药水治疗角结膜上皮内上皮癌(CCIN)的治疗效果。方法分别回顾分析8例8眼经病灶活检及组织病理学检查确诊为CCIN的患者,给予患眼滴用0.04%MMC眼药水,1天4次,1次1滴,连用7天,对于顽固性病变患者采用治疗结束1w后开始下一疗程的循环疗法。所有患者在治疗前曾进行多次局部病灶切除伴随角结膜瘢痕化形成,或病变呈弥漫型表现。在治疗期间第1月,每周检查1次。治疗结束后,每2个月检查1次,连续6月～12月。结果8例8眼CCIN患者局部滴用0.04%MMC眼药水进行治疗,其中7例7眼患者达到角结膜肿物完全消退的临床效果,治疗时间为7天～21天,平均16.8天。治疗后随访时间为8个月～18个月,平均11个月,未见临床复发征象。1例患者治疗35天后达到部分消退,在进行局部肿瘤切除,术后辅助0.04%MMC眼药水治疗1疗程后,随访6月未见复发。治疗期间均伴随有短暂的眼部不适、结膜充血、流泪、畏光和点状角膜上皮病变。未观察到视力的长期损害及泪膜异常。结论根据0.04%MMC对一个完整的表层上皮细胞具有相对无毒性的特征,采用局部滴用MMC辅助治疗CCIN,可以避免多次手术创伤,不仅能够对整个眼表进行治疗,还可以重复使用,尤其对于复发病例,可以作为首选治疗方法,达到了安全、有效的治疗效果。
Objective To evaluate the therapeutic effect of topical drops of 0.04% mitomycin C (MMC) eye drops on the treatment of keratoconjunctival epithelial carcinoma (CCIN). Methods We retrospectively analyzed 8 cases of 8 patients diagnosed as CCIN by pathological biopsy and histopathology. The eye drops were given 0.04% MMC eye drops 4 times a day for 1 time for 7 days. Patients with lesions using the end of the treatment 1w after the beginning of the next cycle of treatment. All patients had multiple local lesion resection accompanied by scarring of corneal conjunctiva before treatment, or diffuse appearance of lesions. In the first month of treatment, check once a week. After treatment, check every 2 months, for 6 months to December. Results Eight patients (8 eyes) with CCIN were treated with 0.04% MMC eye drop. Seven patients (7 eyes) achieved the clinical effect of complete regression of the conjunctival tumor. The treatment time ranged from 7 days to 21 days with an average of 16.8 days. After treatment, follow-up time was 8 months to 18 months, an average of 11 months, no signs of clinical recurrence. One patient had subsided after 35 days of treatment. After partial tumor resection and postoperative adjuvant treatment of 0.04% MMC eye drops for 1 course of treatment, no recurrence was observed in 6 months. During treatment were accompanied by brief eye discomfort, conjunctival congestion, tearing, photophobia and punctate corneal epithelial lesions. Long-term impairment of visual acuity and abnormal tear film were not observed. Conclusions Based on the relatively non-toxic nature of 0.04% MMC for an intact epidermal cell, topical drip MMC assisted therapies to treat CCIN, which avoids multiple surgical trauma, not only treating the entire ocular surface but also reusing it, especially For cases of relapse, can be used as the preferred method of treatment, to achieve a safe and effective treatment.