外用干扰素α -2b和5-氟尿嘧啶治疗眼表鳞状瘤变患者角膜显微结构的变化

Yunjuan Su
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摘要

目的观察外用干扰素α-2b (IFNα-2b)联合5-氟尿嘧啶(5-FU)治疗眼表鳞状瘤变(OSSN)患者角膜显微结构的变化。方法回顾性病例系列研究。16例OSSN患者共16只眼,局部应用IFNα-2b(100万IU/mL)和1% 5-FU,每日4次。采用体内共聚焦显微镜(IVCM)观察治疗前后肿瘤内病变及受累区域下角膜的变化。结果治疗后4个月,OSSN主要表现为上皮细胞反射率降低,细胞多形性丧失,正常组织与肿瘤组织的分界线消失。发现含有亮点的基底细胞层逐渐减少或消失。其他变化是明显的基底下神经的再现。少数树突状细胞呈明亮的细胞颗粒,具有小的树突状突起,转化为大的、高反射的树突状细胞。结论IVCM观察到外用IFNα-2b和5-FU治疗后角膜缘树突状细胞的密度增加,上皮细胞的反射率降低,多形性降低。关键词:肿瘤,鳞状,眼表;树突状细胞;显微术,活体,共聚焦
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The change of corneal microstructural of patients with ocular surface squamous neoplasia after treatment with topical interferon alfa-2b and 5-fluorouracil
Objective To observe the change of corneal microstructural of patients with ocular surface squamous neoplasia (OSSN) after treatment with topical interferon alfa-2b (IFNα-2b) and 5-fluorouracil(5-FU). Methods A retrospective case series study.Total of 16 eyes of 16 patients with OSSN were treated with topical IFNα-2b (1 million IU/mL) and 1% 5-FU four times a day.The inneoplastic lesion and the cornea under involved areas were observed with in vivo confocal microscopy (IVCM) before and after treatment. Results Main features of OSSN at 4 months after treatment showed reduction reflectivity of epithelial cells, loss of cellular pleomorphism and demarcation line between normal and neoplastic tissue. Basal cell layers containing bright dots were found to diminish or disappear gradually. Other change was the reappearance of distinctsubbasal nerves. A few dendritic cells appeared as bright cellular particles with small dendritic processes that transformed into large and highly reflective arborizing cells were found. Conclusion The reduced reflectivity and polymorphhism of epithelial cells, and the increasing density of limbal dendritic cells after topical IFNα-2b and 5-FU therapy are observed with IVCM. Key words: Neoplasia, squamous, ocular surface; Cell, dendritic; Microscopy, in vivo, confocal
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