目的:研究泪腺腺样囊性癌不同病理组织学分型和分级间骨质破坏、神经侵犯和预后的差异。方法:回顾性分析2010年4月至2019年4月首都医科大学附属北京同仁医院眼肿瘤科收治并经病理组织学检测确诊的30例泪腺腺样囊性癌患者的完整病历资料。分析患者的一般病历资料、医学影像学资料、病理组织学检查结果以及预后情况等,并系统研究泪腺腺样囊性癌病理组织学分型和分级与患者预后的关系。结果:30例患者中,病理组织学分型为筛状型9例(30.0%),实体型10例(33.3%),混合型11例(36.7%),其中实性和腺管混合型4例(13.3%)、实性和筛状混合型4例(13.3%)、筛状和腺管混合型3例(10.0%)。病理组织学分级为I级12例(40.0%);II级4例(13.3%);III级14例(46.7%)。不同病理组织学分型肿瘤骨质破坏发生率差异有统计学意义(P=0.046);不同病理组织学分级肿瘤骨质破坏发生率差异无统计学意义(P=0.513)。不同病理组织学分型与分级肿瘤神经侵犯、远处转移发生均无相关性(均P>0.05)。在行手术联合放射治疗后,不同病理组织学分型肿瘤的无复发率差异有统计学意义(P<0.05);实体型的无复发率在36个月内最低(P=0.037);而病理学分级与手术联合放射治疗后的无复发率无关(P=0.059)。结论:泪腺腺样囊性癌病理组织学分型与骨质破坏发生率和复发率显著相关,其中实体型肿瘤较易复发。而病理学分型与神经侵犯和远处转移发生率无关。病理组织学分级与骨质破坏、神经侵犯、远处转移和复发率无显著相关性。
Objective: To investigate the differences in bone destruction, nerve invasion, and prognosis of lacrimal gland adenoid cystic carcinoma (LGACC) among different histologic types and grades. Methods: A retrospective analysis was performed on 30 cases of lacrimal gland adenoid cystic carcinoma confirmed by histopathology who were admitted to the Department of Ophthalmic Oncology, Beijing Tongren Hospital, Capital Medical University from April 2010 to April 2019. The general data, imaging findings, histological examination and prognosis were collected and analyzed, with the focus on the relationship between the histological characteristics and the prognosis of lacrimal gland adenoid cystic carcinoma. Results: Among the 30 patients, 9 cases of cribriform type (30.0%); 10 cases of solid type (33.3%); 11 cases of mixed type (36.7%), including 4 cases of solid and glandular (13.3%), 4 cases of solid and cribriform (13.3%), 3 cases of cribriform and glandular (10.0%). The histopathological grade was I in 12 cases (40.0%), II in 4 cases (13.3%) and III in 14 cases (46.7%). There was statistical difference in the incidence of bone destruction among different histological types (P=0.046). There was no significant difference in the incidence of bone destruction among different histological grades (P=0.513).There was no significant difference between different histological grades and types and the incidence of nerve invasion and distant metastasis (all P>0.05). After surgery combined with radiotherapy, there was a statistical difference in the recurrence-free rate of different histological types, and the recurrence-free rate of solid type was the lowest within 36 months (P=0.037). Histological grade was not associated with recurrence-free rate after surgery combined with radiotherapy (P=0.059). Conclusion: The histological type of adenoid cystic carcinoma of lacrimal gland was significantly correlated with the incidence of bone destruction and recurrence rate, in which solid type was more likely to relapse. And the histological type was not associated with the incidence of nerve invasion or distant metastasis. Histopathological grade was not significantly associated with the rate of bone destruction, nerve invasion, distant metastasis, and recurrence.
目的:研究佛山市禅城区五年级、六年级近视儿童的心理健康及其影响因素,为解决其因近视产生的心理问题及近视防治工作提供依据。方法:选择佛山市禅城区3所小学,在其五年级、六年级选择2个班作为调查对象开展近视筛查、并使用儿童社交焦虑量表、孤独量表以及儿童自尊量表进行心理健康测量。结果:佛山市禅城区近视患病率52.0%,女性(57.5%)较男性(47.4%)有较高患病率,六年级患病率(57.6%)高于五年级(46.3%)。近视儿童均比正常视力儿童存在明显的社交焦虑、孤独感以及低自尊度(得分分别为5.53±4.04 vs 4.66±3.59,30.15±11.72 vs 27.29±10.40,97.97±12.73 vs 100.87±12.21),差异均具有统计学意义(均P<0.05)。进一步分析显示,初发近视社会焦虑、孤独以及自尊方面比中度近视明显。性别、年龄等社会因素对于近视儿童心理健康影响不明显。根据矫正的不同方式分类,近视儿童中,戴角膜塑形镜者社交焦虑感较低(F=4.21,P=0.01),戴框架眼镜者则较容易产生较低的自尊度(F=5.67,P=0.02)。结论:小学生近视问题是全社会普遍关心的问题,近视与其心理健康关系密切,这需要全社会密切配合,采取综合措施,且近视矫正方式的选择影响近视儿童的心理。
Objective: By studying the mental health and its influencing factors of myopia children in grade 5 and grade 6 in Chancheng District, Foshan City, this paper provided the basis for solving the psychological problems caused by myopia and the prevention and treatment of myopia. Methods: Three primary schools in Chancheng District,Foshan City were chosen. Two classes in grade 5 and grade 6 were selected to carry out myopia screening followed by evaluation of their mental health with children’s social anxiety scale, loneliness scale and children’s self-esteem scale. Results: The prevalence of myopia was 52.0% in Chancheng District, Foshan City. Females (57.5%) had a higher prevalence than males (47.4%). The prevalence in grade 6 (57.6%) was higher than that in grade 5 (46.3%).Children with myopia had obvious social anxiety, loneliness, and low self-esteem (scores of 5.53±4.04 vs 4.66±3.59,30.15±11.72 vs 27.29±10.40, 97.97±12.73 vs 100.87±12.21, respectively) than those with normal vision, whose difference was statistically significant (all P<0.05). Further analysis showed that social anxiety, loneliness, and self-esteem in children with primary myopia were more obvious than those with moderate myopia. Social factors such as gender and age had little effect on the mental health of myopic children. According to different correction methods, among myopic children, those who wore orthokeratology lenses had lower social anxiety (F=4.21, P=0.01), and those who wore spectacles were more likely to have lower self-esteem (F=5.67, P=0.02).Conclusion: The problem of myopia in primary school students, which is closely related to mental health, is ofgeneral concern to the whole society. This requires the whole society to cooperate closely and take comprehensive measures. The choice of myopia correction methods affects the psychology of myopic children.