Aim: This study aimed to characterize the clinical and pathologic presentation of ocular surface tumors (OSTs) and to more precisely differentiate the grades of ocular surface squamous neoplasia (OSSN) and benign lesions among Zambians. Methods: Two-hundred sixty-five Zambian patients presenting with ocular surface growths, suspicious for OSSN, were recruited between November 2017 and November 2019 to a cross-sectional study to investigate their lesions. Sociodemographic data were collected, HIV infection status and vision tests were performed, and lesions were measured and documented. Lesions #x3e;2 mm in diameter were excised and sent for pathology analysis. In addition to the biopsies, tears, blood, and buccal swabs were collected. CD4+ T-cell counts were measured by flow cytometry. Lesions were classified according to the WHO guidelines. χ² and bivariate correlations were used to analyze variable associations and strengths with phi/Cramer’s V and correlation coefficients, respectively. Binary logistics was used to adjust for covariance. Results: In this study, 68.3% of the participants were found to be HIV positive. The most frequent diagnoses were invasive OSSN (45.3%), preinvasive OSSN (29.1%), and pterygium (22.6%). Invasive OSSN comprised keratinizing squamous cell carcinoma (SCC) (87.5%), basaloid SCC (3.3%), and spindle cell carcinoma (3.3%). Unusual carcinomas, not described previously, included hybrid SCC (5.0%) and acantholytic SCC (0.8%). Invasive OSSN had advanced tumor (T3/T4) staging (93.3%) at diagnosis. Lymphadenopathy was rare (2.3%), and metastasis was absent. Patients were mostly female (59.2%). Median age was 36 (interquartile ranges 33–41) years (ranges 18–81). Patients with invasive OSSN were more likely to present with pain (p = 0.007), redness (p = 0.034), excessive tearing (p = 0.0001), discharge (p = 0.011), bleeding (p = 0.007), reduced vision (p = 0.0001), fungating lesion (p = 0.001), and blindness (p = 0.005); location at temporal limbus (p = 0.0001), inferior limbus (p = 0.0001), or circumlimbal (p = 0.001); and extension to cornea (p = 0.006) and forniceal palpebral conjunctiva (p = 0.001). Invasive OSSN was associated with any smoking habit and alcohol consumption (p = 0.04 and 0.03, respectively). HIV positivity was strongly associated with OSSN (74.6% OSSN vs. 49.3% benign lesions; p = 0.0001; phi: 0.237 [p = 0.0001]). Conclusion: OSTs are very common in Zambia and are strongly associated with HIV coinfection. Patients with OSSN were more likely to be HIV positive than those with pterygia. Despite the commonality of OSTs in sub-Saharan Africa, these cancers have historically been poorly characterized.
Ocul Oncol Pathol

中文翻译：

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赞比亚原发性眼表肿瘤的临床和病理学表现

目的：本研究旨在描述赞比亚人眼表肿瘤 (OST) 的临床和病理表现，并更准确地区分眼表鳞状瘤 (OSSN) 和良性病变的等级。方法：2017 年 11 月至 2019 年 11 月期间，招募了 265 名出现眼表增生、疑似 OSSN 的赞比亚患者进行横断面研究，以调查他们的病变。收集了社会人口学数据，进行了 HIV 感染状况和视力测试，并测量和记录了病变。病灶#x3e；直径 2 mm 被切除并送去进行病理学分析。除了活组织检查，还收集了泪液、血液和口腔拭子。通过流式细胞术测量 CD4+ T 细胞计数。根据 WHO 指南对病变进行分类。χ2和^双变量相关性分别用于分析变量关联和强度与 phi/Cramer's V 和相关系数。二元物流用于调整协方差。结果：在这项研究中，68.3% 的参与者被发现为 HIV 阳性。最常见的诊断是侵入性 OSSN (45.3%)、侵入前 OSSN (29.1%) 和翼状胬肉 (22.6%)。侵袭性 OSSN 包括角化鳞状细胞癌 (SCC) (87.5%)、基底样 SCC (3.3%) 和梭形细胞癌 (3.3%)。之前未描述的不寻常癌包括混合性 SCC (5.0%) 和棘层松解性 SCC (0.8%)。侵袭性 OSSN 在诊断时具有晚期肿瘤 (T3/T4) 分期 (93.3%)。淋巴结肿大很少见 (2.3%)，并且没有转移。患者大多为女性 (59.2%)。中位年龄为 36 岁（四分位数范围 33-41）岁（范围 18-81）。侵入性 OSSN 患者更可能出现疼痛 ( p = 0.007)、发红 ( p = 0.034)、过度流泪 (p = 0.0001)、分泌物 ( p = 0.011)、出血 ( p = 0.007)、视力下降 ( p = 0.0001)、真菌性病变 ( p = 0.001) 和失明 ( p = 0.005)；位于颞叶缘 ( p = 0.0001)、下缘 ( p = 0.0001) 或环缘 ( p = 0.001)；并延伸至角膜 ( p = 0.006) 和穹窿睑结膜 ( p = 0.001)。侵入性 OSSN 与任何吸烟习惯和饮酒有关（分别为p = 0.04 和 0.03）。HIV 阳性与 OSSN 密切相关（74.6% OSSN 与 49.3% 良性病变；p= 0.0001; phi：0.237 [ p = 0.0001]）。结论： OST 在赞比亚非常普遍，并且与 HIV 合并感染密切相关。OSSN 患者比翼状胬肉患者更容易感染 HIV。尽管 OST 在撒哈拉以南非洲地区很常见，但这些癌症在历史上的特征一直很差。
眼肿瘤病理学