한국인 결막종양의 병리학적 분류와 빈도: 단일기관 연구
Pathological Classification and Incidence of Conjunctival Tumors in Korean Patients: Single-center Study
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목적: 한국인 결막에 발생한 종양의 병리학적 분류 및 발생 빈도에 대하여 알아보고자 한다. 대상과 방법: 2007년 1월부터 2016년 12월까지 순천향대학교 천안병원에 내원한 결막종양 환자 중 절제 생검을 시행받은 환자 234명의 의무기록을 후향적으로 분석하였다. 결막종양 환자의 나이, 발생 부위, 색소 여부 등의 임상 양상과 조직학적 분류와 빈도를 조사하였다. 결과: 절제 생검을 받은 234명의 평균 나이는 37.9 ± 21.6세였고, 구결막에 발생한 경우가 145명(62%)으로 가장 많았고, 색소성 병변을 보이는 경우가 68명(29.2%)이었다. 양성종양이 201명(85.9%), 악성종양은 33명(14.1%)이었다. 조직학적 분류로는 상피세포종양이 71명(30.3%)로 가장 흔하였고, 흑색세포종양이 67명(28.6%), 림프구성 종양이 34명(14.5%), 지방종양이 26명(11.1%)의 빈도를 보였다. 결론: 한국인의 결막종양은 높은 빈도에서 양성종양이 확인되었으며 상피세포종양이 가장 흔하였고, 서양인을 대상으로 한 연구와 달리 흑색세포종양이 적었다. 하지만 임상적으로 악성을 보이는 경우도 14.1%로 드물지 않아 특히 환자의 나이가 많고, 결막낭에 큰 종양이 생겼을 경우 악성의 가능성이 높으므로 조직검사를 통해 정확한 진단과 치료가 필요하다.
Abstract
Purpose: To report the pathological classification and incidence of conjunctival tumors in Korean patients. Methods: A retrospective chart review was conducted for 234 patients who underwent excisional biopsy of conjunctival neoplasia between January 2007 and December 2016 at Soonchunhyang University Hospital. The clinical features, histological classification, and frequency of pigmented conjunctival masses were investigated. Results: The mean age of the 234 patients who underwent excisional biopsy was 37.9 ± 21.6 years. The most common location of conjunctival lesions was the bulbar conjunctiva in 145 patients (62%), with pigmentary lesions in 68 patients (29.2%). Most tumors were benign (n = 201, 85.9%), while 34 malignant tumors were found as follows: 71 patients (30.3%) had epithelial tumors, 67 (28.6%) had melanocytic tumors, 33 (14.1%) had lymphoid tumors, and 26 (11.1%) had lipomatous tumors. Conclusions: Most of the conjunctival tumors in Korean patients were benign. Epithelial tumors were the most common, and melanocytic tumors were less common then in Western studies. However, clinically malignant cases were not uncommon, occurring at a rate of 14.1%. Therefore, conjunctival tumors in elderly patients, lesions that are large, and the presence of a conjunctival sac are more likely to be malignant. Therefore, accurate histological diagnosis and treatment are needed.
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