| Objective: Malignant lymphoma arising in the ocular is a rare disorder,early diagnosis is difficult,this study mainly for the ocular lymphoma's clinical features,pathology,diagnosis,treatment and prognosis evaluation,especially the prognostic factors of ocular adnexal lymphoma MALT were analyzed,and provide clinical data for the standard treatment.Methods: A retrospective study was performed on 96 patients with ocular lymphoma who were treated between 2000 to 2016,diagnosed by the biopsy and immunohistochemistry,including primary intraocular lymphoma patients in 10 cases,primary ocular adnexal lymphomas patients in 86 cases,compared with the clinical characteristics,early performance,involvement of the site,pathological type,treatment and prognosis.The clinical performed using the Ann-Arbor method and the therapeutic efficacy was evaluated according to the IWG criteria.Data were analyzed using SPSS software and Kaplan-Meier curves.The survival rate was calculated by Log-rank method.The qualitative data were analyzed by chi-square and Fisher Probability test.Results: Of the 86 patients with primary ocular lymphoma(POALs),major tumor sites were orbita in 64(74.42%),conjunctiva in 21 patients(24.42%),and lacrimal glands in 1(1.16%),of which MALT lymphoma was the most common one(90.70%).Clinical manifestations are not typical.Factors that influence the prognosis of POALs include pathologic type and treatment regimen,and the pathogenesis is not a risk factor for prognosis.The initial treatment remission rate of the MALT lymphoma in the Ann-Arbor stage I was 97.37% and the 5-year progression-free survival rate was high.Patients treated with radiotherapy or combined with surgery therapy showed a trend for better 5-year RFS than those who were treated with a single modality of surgery therapy.ofsurgertherapy.Primary intraocular lymphoma(PIOL)patients in 10 cases,the performance of vitreous involvement in 8 cases,mostly monocular involvement.The main clinical manifestations of eye foreign body sensation,photophobia,blurred vision.All patients were pathologically classified as diffuse large B-cell lymphoma,monocular involvement of the 7 patients given local treatment(vitreous cavity injection combined with local radiotherapy)were fully relieved,of which 3 patients with relapse,2 patients were followed up for 3 months without recurrence after remedial treatment;2 patients with both eyes involvement were treated with local therapy(vitreous cavity injection + local radiotherapy)combined with systemic chemotherapy,followed up for 12-22 months without recurrence;binocular involvement with the nervous system Symptoms of 1 case of elderly patient died by treatment.Conclusions:1)In patients with primary ocular lymphoma,the proportion of POALs much higher than PIOL,major tumor site was orbita followed by conjunctiva.PIOL occurs in vitreous.2)The most common pathologic types of POALs were MALT lymphoma,followed by follicular lymphoma.The most common pathologic type of PIOL patients was diffuse large B-cell lymphoma.3)POALs have a better prognosis in comparison to other PIOL.The main influencing factors included pathological classification and treatment options,the prognosis of MALT lymphoma was the best;Radiotherapy or radiotherapy combined with surgical treatment program has a high 5-year progression-free survival rate.4)PIOL is a high degree of malignancy,invasive,there was no consensus first-line treatment program,the choice of treatment options need to be assessed according to the affected parts. |
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