Prognostic Biomarkers in Uveal Melanoma: The Status Quo, Recent Advances and Future Directions.
Prognostic Biomarkers in Uveal Melanoma: The Status Quo, Recent Advances and Future Directions.
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DOI：
10.3390/cancers14010096
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发表时间：
2021-12-25
期刊：
影响因子：
5.2
通讯作者：
Hofman P
中科院分区：
文献类型：
--
作者：
Lamas NJ;Martel A;Nahon-Estève S;Goffinet S;Macocco A;Bertolotto C;Lassalle S;Hofman P
虽然罕见，但葡萄膜黑色素瘤（UM）是成人眼睛内最常见的癌症。预后很差，因为50%的患者将在前十年发生致命的转移，特别是转移到肝脏。一旦发现转移，预期寿命是有限的，因为可用的治疗大多不成功。因此，需要找到可以准确预测UM预后的方法以及治疗这种癌症的有效治疗策略。在这篇手稿中，我们初步汇编了目前的知识，流行病学，临床，病理和分子特征的UM。然后，我们涵盖了目前用于UM患者评估和随访的最相关的预后因素。之后，我们强调了在过去三年中发表的UM中新兴的分子标记。最后，我们讨论的问题，防止有意义的进步，UM患者的治疗和诊断，以及预测新的障碍和UM相关的研究路径。葡萄膜黑色素瘤（UM）是成人人群中最常见的恶性眼内肿瘤。它是一种罕见的癌症，发病率为每年每百万居民近5例，由脉络膜（约90%）、睫状体（约60%）或虹膜（约40%）中黑色素细胞的不受控制的增殖发展而来。患者最初要么出现视力模糊或视力减退等症状，要么没有症状，在常规眼科检查中检测到肿瘤。在疾病的过程中，最初处于休眠状态的转移在近50%的患者中发展，优先在肝脏中发展。尽管进行了数十年的深入研究，但唯一被证明可以温和控制疾病扩散的方法是针对消融肝转移的早期治疗，如手术切除或化疗栓塞。然而，一旦检测到转移，大多数患者的预期寿命有限，因为转移性疾病的治疗方法有限，包括免疫治疗，与皮肤黑色素瘤不同，免疫治疗对UM患者大多无效。因此，为了向这些患者提供可能的最佳护理，迫切需要找到可以准确预测UM预后的稳健模型，以及有效阻断和/或限制转移性疾病扩散的治疗策略。在这里，我们初步总结了目前的知识，通过汇编最相关的流行病学，临床，病理和分子数据。然后，我们回顾了目前用于评估和随访原发性UM病例的最重要的预后因素。随后，我们通过全面回顾过去三年进行的研究中产生的基因特征、基于免疫组织化学的标志物和蛋白质组标志物，探讨了UM中新兴的预后生物标志物。最后，我们讨论了该领域目前的障碍，并展望了未来的挑战和新的研究途径在UM。
Although rare, uveal melanoma (UM) is the most common cancer that develops inside adult eyes. The prognosis is poor, since 50% of patients will develop lethal metastases in the first decade, especially to the liver. Once metastases are detected, life expectancy is limited, given that the available treatments are mostly unsuccessful. Thus, there is a need to find methods that can accurately predict UM prognosis and also effective therapeutic strategies to treat this cancer. In this manuscript, we initially compile the current knowledge on epidemiological, clinical, pathological and molecular features of UM. Then, we cover the most relevant prognostic factors currently used for the evaluation and follow-up of UM patients. Afterwards, we highlight emerging molecular markers in UM published over the last three years. Finally, we discuss the problems preventing meaningful advances in the treatment and prognostication of UM patients, as well as forecast new roadblocks and paths of UM-related research. Uveal melanoma (UM) is the most common malignant intraocular tumour in the adult population. It is a rare cancer with an incidence of nearly five cases per million inhabitants per year, which develops from the uncontrolled proliferation of melanocytes in the choroid (≈90%), ciliary body (≈6%) or iris (≈4%). Patients initially present either with symptoms like blurred vision or photopsia, or without symptoms, with the tumour being detected in routine eye exams. Over the course of the disease, metastases, which are initially dormant, develop in nearly 50% of patients, preferentially in the liver. Despite decades of intensive research, the only approach proven to mildly control disease spread are early treatments directed to ablate liver metastases, such as surgical excision or chemoembolization. However, most patients have a limited life expectancy once metastases are detected, since there are limited therapeutic approaches for the metastatic disease, including immunotherapy, which unlike in cutaneous melanoma, has been mostly ineffective for UM patients. Therefore, in order to offer the best care possible to these patients, there is an urgent need to find robust models that can accurately predict the prognosis of UM, as well as therapeutic strategies that effectively block and/or limit the spread of the metastatic disease. Here, we initially summarized the current knowledge about UM by compiling the most relevant epidemiological, clinical, pathological and molecular data. Then, we revisited the most important prognostic factors currently used for the evaluation and follow-up of primary UM cases. Afterwards, we addressed emerging prognostic biomarkers in UM, by comprehensively reviewing gene signatures, immunohistochemistry-based markers and proteomic markers resulting from research studies conducted over the past three years. Finally, we discussed the current hurdles in the field and anticipated the future challenges and novel avenues of research in UM.
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影响因子：
5.2
作者：
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通讯作者：
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作者：
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通讯作者：
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作者：
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