500只眼睛睑缘/眶周皮脂腺癌的分类分析：基于第8版美国癌症联合委员会（AJCC）分期
Eyelid/Periocular Sebaceous Gland Carcinoma in 500 Eyes: Analysis Based on 8th Edition American Joint Cancer Committee Classification
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影响因子:4.2
分区:医学1区 Top / 眼科学1区
发表日期:2025 Jan
作者:
Vijitha S Vempuluru, Vishakha Tanna, Anshika Luthra, Swathi Kaliki
DOI:
10.1016/j.ajo.2024.07.036
keywords:
摘要
本研究旨在根据美国癌症联合委员会（AJCC）第8版分类的预后分期，分析眼睑及眶周皮脂腺癌（SGC）的临床结局。回顾性研究方法：对500只眼睛的SGC病例进行分析。结果显示：根据AJCC第8版分类，肿瘤分为0期（n=13，占3%）、I期（n=158，占32%）、II期（n=269，占54%）、III期（n=48，占9%）及IV期（n=12，占2%）。5年Kaplan-Meier估算显示，区域淋巴结转移、系统转移及相关死亡在II期（分别为12%、11%、12%）、III期（69%、25%、42%）和IV期（70%、100%、100%）的发生率均高于I期（分别为0%、6%、6%）。Cox比例风险分析表明，II期（HR=3.498，95% CI：0.200–10.200，p<0.022）、III期（HR=24.836，95% CI：8.733–70.631，p<0.001）和IV期（HR=53.731，95% CI：15.418–187.253，p<0.001）在淋巴结转移方面的风险较I期明显升高； III期（HR=13.895，95% CI：3.871–49.874，p<0.001）和IV期（HR=81.465，95% CI：22.267–298.051，p<0.001）在系统转移方面的风险也明显增加；在疾病相关死亡方面，III期（HR=9.182，95% CI：2.743–30.728，p<0.001）和IV期（HR=85.237，95% CI：25.331–287.422，p<0.001）的风险也高于I期。第8版AJCC分期的预后分级能有效预测眼睑及眶周SGC患者的预后，且随分期的进展而恶化。淋巴结及系统性转移的高发率是导致这些患者死亡的主要原因。
Abstract
To analyze the outcomes of eyelid and periocular sebaceous gland carcinoma (SGC) based on prognostic stage of the 8th edition of American Joint Committee on Cancer (AJCC) classification.Retrospective study METHODS: Study of 500 eyes with SGC RESULTS: Based on the 8th edition of AJCC classification, tumors belonged to Stage 0 (n=13, 3%), I (n=158, 32%), II (n=269, 54%), III (n=48, 9%), and IV (n=12, 2%). The 5-year Kaplan-Meier estimates of regional lymph node metastasis, systemic metastasis, and metastasis-related death were higher for stage II (12%, 11%, and 12%, respectively), III (69%, 25%, and 42%, respectively) and IV (70%, 100%, and 100%, respectively) compared to stage I (0%, 6%, and 6%, respectively). Cox proportional analysis revealed a greater hazard ratio (HR) for lymph node metastasis in stage II (HR, 3.498; 95% CI, 0.200 to 10.200; p<0.022), III (HR, 95% CI, 24.836; 8.733 to 70.631; p<0.001), and IV (HR, 53.731; 95% CI, 15.418 to 187.253; p<0.001), systemic metastasis in stage III (HR. 13.895; 95% CI, 3.871 to 49.874; p<0.001) and IV (HR, 81.465; 95% CI, 22.267 to 298.051; p<0.001) and for disease-related death in stage III (HR, 9.182; 95% CI, 2.743 to 30.728; p<0.001) and IV (HR, 85.237; 95% CI, 25.331 to 287.422; p<0.001), compared to stage I.The prognostic staging of the 8th edition AJCC classification predicts the prognosis of patients with eyelid and periocular SGC, which worsens with the advancing stage. The high incidence of lymph node and systemic metastasis accounts for mortality in these patients.