Klinik olarak pterjiyum tanısı alan hastaların demografik özellikleri ve pterjiyum cerrahisi geçiren hastaların patoloji sonuçlarının retrospektif olarak incelenmesi
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Dosyalar
Tarih
2024
Kurum Yazarları
Abdullayeva, Nigar
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
Bursa Uludağ Üniversitesi
Özet
Amaç: Üçüncü basamak olarak hizmet veren hastanemizde ameliyat edilmiş pterjiyum olgularının biyopsi sonuçlarının incelenmesi, beklenmedik oküler yüzey yassı hücreli neoplazi ( OYYHN) prevalansının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bursa Uludağ Üniversitesi Göz Hastalıkları Anabilim Dalı’nda Ocak 2017-Nisan 2023 tarihleri arasında pterjiyum ameliyatı uygulanan veya patoloji sonucu pterjiyum olan 190 hastanın 205 gözünün dosyaları retrospektif olarak incelenmiştir. Hastaların demografik verileri, biyopsi materyallerinin histopatoloji sonuçları incelenmiştir, patolojik incelemede şüpheli olgularda immunohistokimyasal ve histokimyasal boyalar kullanıldığı izlenmiştir. Patolojik inceleme sonucu pterjiyum olan 89 hasta ile pterjiyum zemininde neoplazi olan 8 hastanın verileri kıyaslanmıştır. Pterjiyum ameliyatı yapılmış, fakat biyopsi alınmamış 100 göz istatistiksel kıyaslama dışında tutulmuştur. Bulgular: Biyopsisi alınan 105 olgunun patoloji sonucu 97 (%92,4)gözde pterjiyum (grup P), 8 (%7,6) gözde pterjiyum zemininde neoplazi (grupN) olarak raporlanmıştı. Grup P’de 33 (%37,0) kadın, 56 (%64,9) erkek olguvardı, ortalama yaş 55,7 yıl, ortalama takip süresi 7,6 hafta idi. Çoğunluk (%66,2) Akdeniz ikliminde yaşıyor, 46’sı (%51,7) sigara içmiyor idi. Dış ortamla ilintili mesleği olanların oranı % 46,2 idi. Grup N’de 1’i (%12,5) kadın, 7’si (%87,5) erkek toplam 8 olgu mevcuttu. Ortalama yaş 51,9 yıl, ortalama takip süresi 12,4 hafta idi. Patolojik incelemede 6’sında (%75) konjonktival intraepiteliyal neoplazi, 2’sinde (%25) karsinoma in situ görülmüş, bütün olgular pterjiyum zemininde gelişmişti. Çoğunluk (%75,0) Akdeniz ikliminde yaşıyor, %50,0’si sigara içmiyor idi. En sık meslek sanayicilik (%37,5) idi.Sonuç: Çalışmada Grup P ile Grup N arasında demografik verilerde istatistiksel fark bulunmamıştır. Beklenmedik OYYHN ile karşılaşılmamıştır. OYYHN sadece klinik olarak şüphelenilen olgularda görülmüştür. Çalışmamızdaki düşük OYYHN oranının ülkemizde yüksek olmayan ultraviole (UV) maruziyetine bağlı olduğu düşünülmektedir. Klinik tecrübe ve yüksek çözünürlüklü oküler koherens tomografi’nin (YÇ-OKT) kullanımı ile, ameliyattan önce pterjiyum ve OYYHN ayırt edilerek uygun tedavi yöntemi seçilmesi sağlanmıştır. Klinisyenin lezyon içerisindeki potansiyel maligniteyi tanımlayacak kadar yeterli tecrübesinin olmadığı veya YÇ-OKT'nin bulunmadığı kliniklerde, pterjiyum örneklerinin rutin histopatolojik incelenmesi tavsiye edilir.
Purpose: It emerged as a result of examining the antibiotic results of pterygium cases operated on in a tertiary hospital and evaluating the expected prevalence of ocular surface squamous cell neoplasia (OSSN). Materials and Methods: The files of 205 eyes of 190 patients who underwent pterygium surgery or had pterygium as a result of pathology at Bursa Uludağ University, Department of Ophthalmology, between January 2017 and April 2023 were retrospectively examined. The demographic data of the patients and the histopathology results of the biopsy materials were examined, and it was observed that immunohistochemical and histochemical dyes were used in suspicious cases in the pathological examination. The data of 89 patients with pterygium as a result of pathological examination and 8 patients with neoplasia based on pterygium were compared. 100 eyes that underwent pterygium surgery but did not have a biopsy were excluded from statistical comparison. Results: The pathology result of 105 cases whose biopsies were taken was reported as pterygium (group P) in 97 eyes (92.4%) and neoplasia based on pterygium (group N) in 8 (7.6%) eyes. There were 33 (37.0%) female and 56 (64.9%) male cases in Group P, the average age was 55.7 years, and the average follow-up period was 7.6 weeks. The majority (66.2%) lived in a Mediterranean climate, and 46 (51.7%) were non-smokers. The rate of thosewho had a profession related to the outdoor environment was 46.2%. Therewere a total of 8 cases in Group N, 1 (12.5%) female and 7 (87.5%) male. Theaverage age was 51.9 years and the average follow-up period was 12.4 weeks. Pathological examination revealed conjunctival intraepithelial neoplasia in 6 (75%) and carcinoma in situ in 2 (25%), and all cases developed on the basis of pterygium. The majority (75.0%) lived in a Mediterranean climate and 50.0% were non-smokers. The most common profession was industrialism (37.5%). Conclusion: In the study, no statistical difference was found in demographic data between Group P and Group N. No unexpected OSSN was encountered. OSSN has only been seen in clinically suspected cases. It is thought that the low rate of OSSN in our study is due to ultraviolet (UV) exposure, which is not high in our country. With clinical experience and the use of high-resolution ocular coherence tomography (HR-OCT), pterygium and OSSN were distinguished before surgery and the appropriate treatment method was selected. In clinics where the clinician does not have sufficient experience to identify potential malignancy within the lesion or where HR-OCT is not available, routine histopathological examination of pterygium samples is recommended.
Purpose: It emerged as a result of examining the antibiotic results of pterygium cases operated on in a tertiary hospital and evaluating the expected prevalence of ocular surface squamous cell neoplasia (OSSN). Materials and Methods: The files of 205 eyes of 190 patients who underwent pterygium surgery or had pterygium as a result of pathology at Bursa Uludağ University, Department of Ophthalmology, between January 2017 and April 2023 were retrospectively examined. The demographic data of the patients and the histopathology results of the biopsy materials were examined, and it was observed that immunohistochemical and histochemical dyes were used in suspicious cases in the pathological examination. The data of 89 patients with pterygium as a result of pathological examination and 8 patients with neoplasia based on pterygium were compared. 100 eyes that underwent pterygium surgery but did not have a biopsy were excluded from statistical comparison. Results: The pathology result of 105 cases whose biopsies were taken was reported as pterygium (group P) in 97 eyes (92.4%) and neoplasia based on pterygium (group N) in 8 (7.6%) eyes. There were 33 (37.0%) female and 56 (64.9%) male cases in Group P, the average age was 55.7 years, and the average follow-up period was 7.6 weeks. The majority (66.2%) lived in a Mediterranean climate, and 46 (51.7%) were non-smokers. The rate of thosewho had a profession related to the outdoor environment was 46.2%. Therewere a total of 8 cases in Group N, 1 (12.5%) female and 7 (87.5%) male. Theaverage age was 51.9 years and the average follow-up period was 12.4 weeks. Pathological examination revealed conjunctival intraepithelial neoplasia in 6 (75%) and carcinoma in situ in 2 (25%), and all cases developed on the basis of pterygium. The majority (75.0%) lived in a Mediterranean climate and 50.0% were non-smokers. The most common profession was industrialism (37.5%). Conclusion: In the study, no statistical difference was found in demographic data between Group P and Group N. No unexpected OSSN was encountered. OSSN has only been seen in clinically suspected cases. It is thought that the low rate of OSSN in our study is due to ultraviolet (UV) exposure, which is not high in our country. With clinical experience and the use of high-resolution ocular coherence tomography (HR-OCT), pterygium and OSSN were distinguished before surgery and the appropriate treatment method was selected. In clinics where the clinician does not have sufficient experience to identify potential malignancy within the lesion or where HR-OCT is not available, routine histopathological examination of pterygium samples is recommended.
Açıklama
Anahtar kelimeler
Pterjiyum, Oküler yüzey yassı hücreli neoplazi, Ultraviole indeks, Pterygium, Ocular surface squamous cell neoplasia, Ultraviolet index
Alıntı
Abdullayeva, N. (2024). Klinik olarak pterjiyum tanısı alan hastaların demografik özellikleri ve pterjiyum cerrahisi geçiren hastaların patoloji sonuçlarının retrospektif olarak incelenmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.