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Objective:To evaluate the influence of the clinical staging and different risk factors for the prognosis of ocular adnexal lymphoma.Methods:An ambispective cohort study was conducted.Seventy-four patients diagnosed with primary ocular adnexal lymphoma by pathology at Tianjin Medical University Eye Hospital from November 2010 to December 2018 were enrolled.TNM staging was performed according to local tumor extent, lymph node or systemic involvement.Ann Arbor staging was carried out according to lymph node involvement and extranodal extension.The pathological subtype was classified according to World Health Organization classification of lymphoma.The outcome of disease progression or death was analyzed.Kaplan-Meier method was used for univariate survival analysis.Cox proportional hazard model was employed for multivariate survival analysis to predict the risk factors affecting prognosis, hazard ratio ( HR) and 95% confidence interval ( CI) were estimated.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY[L]-32). Written informed consent was obtained from all patients before entering the cohort. Results:For TNM staging, there were 68 cases in stage <T4, accounting for 91.9%, 6 cases in T4, accounting for 8.1%, 71 cases in N0, accounting for 95.9%, 3 cases in ≥N1, accounting for 4.1%, and no case was in stage M. For Ann Arbor staging, there were 72 cases in stage ⅠE, accounting for 97.3%, and 2 cases in stage ⅡE, accounting for 2.7%.As for pathological classification, 64 cases had mucosa-associated lymphoid tissue (MALT) lymphoma, accounting for 86.5% and 10 cases had non-MALT lymphoma, accounting for 13.5%.The follow-up of the patients was 3 to 117 months, with a median follow-up of 53 months.There were 6 cases dying of disease and 19 cases progressed.The 3-year and 5-year overall survival rates were 96.6% and 86.6%, respectively.The 3-year and 5-year progression-free survival rates were 75.6% and 65.9%, respectively.According to single-factor analysis, T4 stage, non-MALT type and Ki67 positive rate ≥10% were related to declined overall survival rate ( P<0.05). T4 stage, ≥N1 stage, ≥Ann Arbor Ⅱ stage, non-MALT type and Ki67 positive rate ≥10% were related to declined progression-free survival rate ( P<0.05). According to multiple-factor analysis, pathological type ( HR=33.193, 95% CI: 3.388-325.156, P=0.003) was the independent risk factor for overall survival rate.N stage ( HR=11.683, 95% CI: 2.720-50.173, P=0.001) and pathological type ( HR=11.337, 95% CI: 3.841-33.464, P<0.001) were independent risk factors for progression-free survival rate. Conclusions:TNM staging and pathological type are important clinical prognostic indicators for ocular adnexal lymphoma.Patients with high TNM stage or non-MALT lymphoma should be monitored closely.
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Objective To summarize the clinical characteristics and prognosis of lacrimal gland adenoid cystic carcinoma with high-grade transformation (LACC-HGT).Methods A retrospective study was adopted.Seventeen patients with lacrimal gland adenoid cystic carcinoma (LACC) were collected from August 2008 to March 2017 in Tianjin Medical University Eye Hospital.Hematoxylin-eosin staining and immunohistochemical staining were performed on tumor sections of 17 LACC patients.According to the pathology results,the patients were divided into LACC-HGT group (6 patients) and non-LACC-HGT (NLACC-HGT)group (11 patients),and the clinical characteristics and prognosis of the two groups were analyzed by using Fisher's exact test and Log-Rank test.Results The medical histories,clinical features,imaging features,TNM staging and treatment protocols were not significantly different between the two groups (all at P＞ 0.05).The 2-year local recurrence rate,5-year distant metastasis rate and 5-year death rate of patients with LACC-HGT were significantly higher than patients with NLACC-HGT (all at P＜0.05).Survival analysis results showed that the survival time of LACC-HGT group was obviously shorter than that of NLACC-HGT group.Conclusions LACC-HGT accelerate the invasion process of local recurrence and distant metastasis,and enhance the death rate.The detection of HGT components should be considered in the process of LACC diagnosis.
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Objective To investigate the effectiveness of treatment of primary orbital varix via venous embolization therapy approach. Methods From January 2007 to January 2015,the clinical data of 12 patients with primary orbital varix were analyzed retrospectively. All the micro-catheters were implanted via the inferior petrosal sinus approach. The microcoils and Onyx18 were used to embolize the primary orbital varix. Four patients were embolized with micro-coils only, three were embolized with Onyx, and five were embolized with microcoil + Onyx. Results After successful catheterization, the lesions were totally embolized in 12 patients. The symptoms of postural exophthalmos disappeared and the pain was relieved,the depressed symptom of eyeball disappeared in 10 cases, and two patients were relieved partially ( single material embolization) . Nine patients were followed up for 6 to 24 months. The orbital DSA,MRI or CT re-examination was performed. The thrombosis of orbital varices within the lesions was observed and no cavity was found. One of the patients suffered from limited lateral eyeball abduction. Another three were lost to follow up. Conclusion The embolization treatment of primary orbital varix is safe, effective, and convenient via inferior petrosal sinus approach.
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Objective To observe vasculogenic mimicry (VM) of human choroidal melanoma cell line OCM-1 cultured in vitro and the expression of PI3K and EphA2 protein,as well as to explore the possible mechanisms.Methods OCM-1 cells were cultured in vitro and stained with periodic acid Schiff (PAS) on days 7,which aimed to observe the formation of PAS-positive cyclic structures,that is,VM formation.Then immunohistochemical staining was performed to detect PI3K and EphA2 on day 1,4,7 and the results were observed.Ressults On day 4 of 3-demintional culture,most of OCM-1 cells were polygonal and the cytoplasm was abundant;the nuclei were round and the nucleoli were visible.A small part of the tumor cells were long spindle.It was found that several long spindle cells were connected to each other to form hemicyclic structure.After 7 days,a large number of tumor cells became long spindle,growing along the collagen scaffold,and long protrusions appeared,forming a ring structure.PAS staining showed that the tumor cells were mostly arranged in a row,and tumor cells imitated the formation of body blood vessels,resulting in cell band and pipeline-like cell layers,with one layer of extracellular matrix (PAS-positive substance) making up the ring structure.Moreover,the expression levels of PI3K and EphA2 on day 4 and 7 were significantly higher than those on day 1 (all P ＜ 0.05),and their expression levels on day 7 were higher than those on day 4 (all P ＜ 0.05).Conclusion EphA2 and PI3K may play an important role in the VM formation in 3-dimentional culture of human choroidal melanoma cell line OCM-1.
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Objective To investigate the effectiveness of treatment of primary orbital varix via venous embolization therapy approach. Methods From January 2007 to January 2015,the clinical data of 12 patients with primary orbital varix were analyzed retrospectively. All the micro-catheters were implanted via the inferior petrosal sinus approach. The microcoils and Onyx18 were used to embolize the primary orbital varix. Four patients were embolized with micro-coils only, three were embolized with Onyx, and five were embolized with microcoil + Onyx. Results After successful catheterization, the lesions were totally embolized in 12 patients. The symptoms of postural exophthalmos disappeared and the pain was relieved,the depressed symptom of eyeball disappeared in 10 cases, and two patients were relieved partially ( single material embolization) . Nine patients were followed up for 6 to 24 months. The orbital DSA,MRI or CT re-examination was performed. The thrombosis of orbital varices within the lesions was observed and no cavity was found. One of the patients suffered from limited lateral eyeball abduction. Another three were lost to follow up. Conclusion The embolization treatment of primary orbital varix is safe, effective, and convenient via inferior petrosal sinus approach.
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Background Pterygium is one of the common ocular surface disorders,and the main drugs for pterygium include dexamethasone (DXM),interferon α-2b (IFN-α2b),mitomycin C (MMC),5-fluorouracil (5-FU),cyclosporin A (CsA) and tacrolimus (FKS06).However,the efficacy of these drugs on the fibroblasts from recurrence pterygium is unelucidated.Objective This study was to compare the efficacy of DXM,IFN-o2b,MMC,5-FU,CsA and FK506 on proliferation and apoptosis of recurrent pterygium-derived fibroblasts in vitro.Methods The specimens of recurrence pterygium were collected during surgery in Tianjin Medical University Ophthalmological Hospital from May 2015 to July 2016 under the written informed consent.Fibroblasts were isolated and cultured by explant culture method and identified by immunochemistry.DXM,IFN-α2b,MMC,5-FU,CsA and FK506 were added into the medium for 48 hours,respectively,and the cells cultured without drug were used as the control group.The inhibitory efficiency of different concentrations of DXM,IFN-α2b,MMC,5-FU,CsA and FK506 on the cell proliferation was assayed by cell counting kit-8 (CCK-8),and 50％ inhibiting concentration (IC50) of the drugs was calculated.The cells were treated by the IC50 dose of drugs for 48 hours,and cell apoptotic proportion and cell cycle were assessed by flow cytometry analysis.The expression of proliferating cell nuclear antigen (PCNA) in the cells after treated by drugs was detected by immunochemistry.Results Cultured cells grew well with the fusiform shape and radial arrangement.Vimentine showed the positive expression and keratin was absently expressed in the cells.The IC50 to the cells was (3.5×103±2.83×10-2)mg/L,(6.1×102±3.6×10-3)mg/L,(3.2×10-1±1×10-4)mg/L,(2.2× 101 ± 1.2× 10-3) mg/L,(6.3 × 101 ±2.5 × 10-3) mg/L and (6.0× 101 ± 0.0× 100) mg/L in the DXM,IFN-α2b,MMC,5-FU,CsA and FK506,respectively.In the 48 hours after treated by the IC50 drugs,the apoptotic ratio was (35.00± 3.21)％,(30.37±1.67)％,(26.11±0.75)％,(22.01±0.07)％,(20.95±1.68)％ and (19.85±0.52)％ in the IFN-α2b group,CsA group,MMC group,FK506 group,DXM group and 5-FU group,which was significantly higher than (11.38±2.18) ％ in the control group (all at P＜0.05).The cell proportion of G0/G1 phase,S phase and G2/M phase was (85.64±2.62)％,(5.29±1.56)％ and (2.73-±2.66)％ in the control group,and the cell proportion of G0/G1 phase was reduced,while that of S phase or G2/M phase was considerably increased in various drug groups (all at P＜0.05),with the blocking efficiency of cell cycle was in turn MMC,CsA,5-FU,DXM,IFN-α2b and FK506.The expressional rate of PCNA in the cells was (95.00 ± 2.00) ％,(82.67 ± 5.04) ％,(80.00 ± 2.78) ％,(64.00± 6.55)％,(38.00±3.00)％,(32.00±4.36)％ and (29.67±3.02)％ in the control group,FK506 group,DXM group,5-FU group,IFN-α2b group,CsA group and MMC group,showing a significant difference among the groups (F=25.995,P＜0.01),and the expressional rate of PCNA was significant lower in various drug groups than that in the control group (all at P＜0.05).Conclusions DXM,IFN-α2b,MMC,5-FU,CsA and FK506 are all able to inhibit the proliferation and promote the apoptosis of recurrent pterygium-derived fibroblasts in vitro,and MMC and CsA appear to have a stronger effect.