Clinical and Pathologic Characteristics of Biopsy-Proven Iris Melanoma A Multicenter International Study
Clinical and Pathologic Characteristics of Biopsy-Proven Iris Melanoma A Multicenter International Study
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DOI：
10.1001/archophthalmol.2011.286
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发表时间：
2012-01-01
影响因子：
--
通讯作者：
Damato, Bertil E.
中科院分区：
文献类型：
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作者：
Khan, Samira;Finger, Paul T.;Damato, Bertil E.
目的：与多个中心合作，确定虹膜黑色素瘤的代表性流行病学、临床和病理学特征。这项国际、多中心、互联网辅助的眼科肿瘤学研究展示了眼癌专家之间的合作，以分期和描述经活检证实的虹膜黑色素瘤的临床和病理特征。方法：创建了一个计算机程序，以允许互联网辅助的多中心、隐私保护的在线数据输入。 6 个国家的 8 个眼癌中心进行了回顾性图表审查。统计分析包括患者和肿瘤特征、眼睛和角度异常、治疗、组织病理学和结果。结果：共有 131 名虹膜黑色素瘤患者（平均年龄，64 岁[范围，20-100 岁]）被发现有蓝灰色（62.2%）、绿榛色（29.1%）或棕色（8.7%）虹膜。虹膜黑色素瘤颜色为棕色（65.6%）、无黑色（9.9%）和彩色（6.9%）。平均 2.5 小时的虹膜明显与黑色素瘤有关，通常集中在 6 点钟子午线。报告内容包括虹膜炎、青光眼、前房出血和扇形白内障。高频超声检查显示最大平均肿瘤直径为 4.9 毫米，平均最大肿瘤厚度为 1.9 毫米，角度钝化 (52%)、虹膜根脱出 (9%) 和后虹膜色素上皮移位 (9%)。使用美国癌症联合委员会-国际抗癌联盟分类，我们将 56% 的肿瘤确定为 T1，34% 的肿瘤为 T2，2% 的肿瘤为 T3，1% 的肿瘤为 T4。组织病理学分级为G1-纺锤体（54%）、G2-混合（28%）、G3-上皮样（5%）和未确定（13%）细胞类型。主要治疗包括放疗（26%）和手术（64%）。 Kaplan-Meier 分析发现 5 年内发生转移性黑色素瘤的风险为 10.7%。结论：虹膜黑色素瘤最有可能呈棕色，并发现于虹膜浅色患者的下象限。黑色素瘤通常较小且单灶，通常与角钝化和梭形细胞组织病理学相关。这项多中心、基于互联网的国际研究成功地汇集了数据并提取了经活检证实的虹膜黑色素瘤的信息。
Objective: To collaborate with multiple centers to identify representative epidemiological, clinical, and pathologic characteristics of melanoma of the iris. This international, multicenter, Internet-assisted study in ophthalmic oncology demonstrates the collaboration among eye cancer specialists to stage and describe the clinical and pathologic characteristics of biopsy-proven melanoma of the iris.Methods: A computer program was created to allow for Internet-assisted multicenter, privacy-protected, online data entry. Eight eye cancer centers in 6 countries performed retrospective chart reviews. Statistical analysis included patient and tumor characteristics, ocular and angle abnormalities, management, histopathology, and outcomes.Results: A total of 131 patients with iris melanoma (mean age, 64 years [range, 20-100 years]) were found to have blue-gray (62.2%), green-hazel (29.1%), or brown (8.7%) irides. Iris melanoma color was brown (65.6%), amela-notic (9.9%), and multicolored (6.9%). A mean of 2.5 clock hours of iris was visibly involved with melanoma, typically centered at the 6-o'clock meridian. Presentations included iritis, glaucoma, hyphema, and sector cataract. High-frequency ultrasonography revealed a largest mean tumor diameter of 4.9 mm, a mean maximum tumor thickness of 1.9 mm, angle blunting (52%), iris root disinsertion (9%), and posterior iris pigment epithelium displacement (9%). Using the American Joint Commission on Cancer-International Union Against Cancer classification, we identified 56% of tumors as T1, 34% of tumors as T2, 2% of tumors as T3, and 1% of tumors as T4. Histopathologic grades were G1-spindle (54%), G2-mixed (28%), G3-epithelioid (5%), and undetermined (13%) cell types. Primary treatment involved radiation (26%) and surgery (64%). Kaplan-Meier analysis found a 10.7% risk of metastatic melanoma at 5 years.Conclusions: Iris melanomas were most likely to be brown and found in the inferior quadrants of patients with light irides. Typically small and unifocal, melanomas are commonly associated with angle blunting and spindle cell histopathology. This multicenter, Internet-based, international study successfully pooled data and extracted information on biopsy-proven melanoma of the iris.