Uveal Melanoma: Molecular Pattern, Clinical Features, and Radiation Response
Uveal Melanoma: Molecular Pattern, Clinical Features, and Radiation Response
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DOI：
10.1016/j.ajo.2012.02.022
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发表时间：
2012-08-01
影响因子：
4.2
通讯作者：
Phillips, Theodore L.
中科院分区：
文献类型：
--
作者：
Chappell, Michael C.;Char, Devron H.;Phillips, Theodore L.
目的：探讨1级和2级葡萄膜黑色素瘤的临床特征及其与眼内质子辐射反应的关系。设计：基于细针活检分子谱的葡萄膜黑色素瘤患者的蒙面回顾性病例系列。方法：对来自同一医院的197例葡萄膜黑色素瘤患者的病理、临床特征和对放射治疗的反应进行分析。结果：1级肿瘤126例（64%），2级肿瘤71例（36%）。2级肿瘤患者的年龄更大（平均：64岁对57岁，P = 0.001），初始平均超声测量更厚（7.4 mm对5.9 mm, P = 0.0007），细胞病理学上更可能有上皮样细胞或混合细胞（66%对38%，P = 0.0004）。虽然1类和2类肿瘤的平均术前和术后超声厚度有显著差异，但放射治疗后24个月的平均厚度变化无差异（平均差异：1类= -1.64 mm， 2类= -1.47;P = 0.47）或总体厚度变化率无差异（斜率：P = 0.64）。2级肿瘤比1级肿瘤更容易转移和死亡（DSS: P < 0.0001）。结论：放疗时肿瘤变厚、上皮样病理及患者年龄增大与2级肿瘤显著相关，2级肿瘤导致较高的肿瘤相关死亡率。我们没有发现区分1级和2级肿瘤的明确临床标志。[J]中华眼科杂志，2012;24(4):379 - 379。(c) 2012年Elsevier Inc.版权所有。)
PURPOSE: To characterize the clinical spectrum of class 1 and class 2 uveal melanomas and their relationship with intraocular proton radiation response.DESIGN: Masked retrospective case series of uveal melanoma patients with fine needle biopsy-based molecular profiles.METHODS: A total of 197 uveal melanoma patients from a single institution were analyzed for pathology, clinical characteristics, and response to radiation therapy.RESULTS: A total of 126 patients (64%) had class 1 tumors and 71 (36%) had class 2 tumors. Patients with class 2 tumors had more advanced age (mean: 64 years vs 57 years; P = .001), had thicker initial mean ultrasound measurements (7.4 mm vs 5.9 mm; P = .0007), and were more likely to have epithelioid or mixed cells on cytopathology (66% vs 38%; P = .0004). Although mean pretreatment and posttreatment ultrasound thicknesses were significantly different between class 1 and class 2 tumors, there was no difference in the mean change in thickness 24 months after radiation therapy (mean difference: class 1 = -1.64 mm, class 2 = -1.47; P = .47) or in the overall rate of thickness change (slope: P = .64). Class 2 tumors were more likely to metastasize and cause death than class 1 tumors (DSS: P < .0001).CONCLUSIONS: At the time of radiation therapy, thicker tumors, epithelioid pathology, and older patient age are significantly related to class 2 tumors, and class 2 tumors result in higher tumor-related mortality. We found no definitive clinical marker for differentiating class 1 and class 2 tumors,. (Am J Ophthalmol 2012; 154:227-232. (c) 2012 by Elsevier Inc. All rights reserved.)