Conjunctival melanoma (Co-M) is an aggressive, invasive eye and eyelid cancer. Its global incidence of ~1 in a million is increasing at a rate ratio of ~1.4, but this rises sharply in over 65-year-olds. Although rare, Co-M has a devastating impact on the lives of those who develop it. Co-M is often misdiagnosed or overlooked, leading to vision loss either from the destructive effects of the tumour or side effects of therapy, facial disfigurement from radical surgery, and death from metastases. Due to its rarity, there is limited evidence for diagnosis and management; hence, there is no standardised treatment and not all cases are referred to a specialised ocular oncology centre. Recent progress in cancer immunology and genetics have revolutionised the treatment of cutaneous melanomas, which share some similarities to Co-M. Importantly, a better understanding of Co-M and its precursor lesions is urgently needed to lead to the development of novel targeted and immunotherapies both for local tumour control and disseminated disease. This review aims to provide a comprehensive clinical overview of the current knowledge regarding Co-M, its epidemiology, pathogenesis, presentation, diagnosis and recent changes in the classification of its precursor lesions, management, and recent advances in novel biological therapies for personalised treatment of this disease.
结膜黑色素瘤（Co-M）是一种侵袭性强的眼部和眼睑恶性肿瘤。其全球发病率约为百万分之一，且正以约1.4的速率比持续上升，其中65岁以上人群的发病率急剧增高。尽管罕见，Co-M对患者的生活具有毁灭性影响。该病常被误诊或忽视，可能导致因肿瘤破坏或治疗副作用引起的视力丧失、根治性手术导致的面部毁容，以及转移导致的死亡。由于其罕见性，诊断和治疗方面的证据有限，因此缺乏标准化治疗方案，且并非所有病例都能转诊至专业的眼肿瘤中心。近年来癌症免疫学和遗传学的进展已彻底改变了皮肤黑色素瘤的治疗策略，而该病与Co-M存在一定相似性。亟需加强对Co-M及其前驱病变的认识，以推动针对局部肿瘤控制和转移性疾病的新型靶向及免疫疗法的研发。本综述旨在全面概述当前关于Co-M的临床认知，包括其流行病学、发病机制、临床表现、诊断方法、前驱病变分类的最新变化、治疗策略，以及针对该疾病个性化治疗的新型生物疗法的最新进展。
肿瘤(癌症)患者之家