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目的:研究55例结膜鳞状细胞癌的流行病学、临床特点,以及艾滋病毒对其发病情况的影响。方法:横断面研究,纳入就诊于阿比让特雷什维尔大学医院眼科的54例55眼结膜鳞状细胞癌患者。收集的数据包括书面问卷、眼科检查、病理检查、HIV血清学检查、治疗情况(手术及化疗)、随访情况和预后。结果:患者年龄为7~75(平均42.28)岁。女性占53%。发病到就诊时间6~60(平均18)mo。患者平均随访29mo。共有53%(29眼)无视功能。54例患者中42例HIV阳性,28例为HIV1感染,4例为HIV2感染,10例为混合感染。这42例患者中28例进行了淋巴细胞分类检查,结果显示33%的患者CD4细胞计数<200/m L,19%的患者200~500/mL,12%的患者>500/m L。42眼(76%)为侵袭性分化型鳞状细胞癌,13眼(24%)为原位癌。40例(73%)局部肿瘤进行了肿块切除,其中6例进行了术后局部辅助化疗。社会经济情况分析显示39%的患者经济情况较差。结论:HIV感染是结膜鳞状细胞癌发病的危险因素,尤其是在撒哈拉以南的非洲。这一疾病不良预后可能与患者社会经济情况较差,我们治疗机构中医疗资源不足,抗肿瘤药物治疗经费较少有关,HIV感染也对疾病有一定影响。
Objective: To study the epidemiology and clinical features of 55 cases of conjunctival squamous cell carcinoma and the impact of HIV on its incidence. METHODS: A cross-sectional study of 54 patients with 55 conjunctival squamous cell carcinomas admitted to the Ophthalmology Department of the University of Trafalgar Hospital Abidjan was included. Data collected included written questionnaires, eye exams, pathological exams, HIV serology, treatment (surgery and chemotherapy), follow-up and prognosis. Results: The patient’s age ranged from 7 to 75 (mean, 42.28) years. Women make up 53%. The onset to treatment time 6 to 60 (average 18) mo. Patients were followed up for an average of 29 months. A total of 53% (29 eyes) ignored the function. Of the 54 patients, 42 were HIV positive, 28 were HIV1, 4 were HIV2 and 10 were mixed. Twenty-eight of the 42 patients underwent a lymphoproliferative examination and showed a CD4 cell count of <200 / m L in 33%, 200-500 / mL in 19%, and> 500 / m L in 12% of patients. Forty-two eyes (76%) were invasive differentiated squamous cell carcinoma and 13 (24%) were carcinoma in situ. Forty (73%) of the local tumors were resected, and 6 of them received postoperative local adjuvant chemotherapy. Socioeconomic analysis shows that 39% of patients are in poor economic conditions. Conclusion: HIV infection is a risk factor for the onset of conjunctival squamous cell carcinoma, especially in sub-Saharan Africa. The unfavorable prognosis of this disease may be related to the poor social and economic conditions of patients, inadequate medical treatment resources in our treatment facilities and less funding for anti-cancer drug treatment. HIV infection also has some impact on the disease.