UVEAL MELANOMA: IMMUNOLOGIC STUDIES

葡萄膜恶性黑色素瘤的生物学特性很复杂。最近发生的冲突 文献表明，标准的眼球摘除技术可以 实际上是在扩散肿瘤细胞或减少患者的 免疫能力，导致转移疾病。正因如此，一些人 作者甚至建议不要为葡萄膜病患者摘除眼球 恶性黑素瘤。在另一个极端，一些作者建议 每只有葡萄膜黑色素瘤的眼睛都要摘除眼球，即使没有 可检测到的增长。这项提案将着眼于各种免疫学 葡萄膜恶性黑色素瘤患者的参数 威尔斯眼科医院肿瘤科服务。有待研究的参数 包括：细胞质黑色素瘤的肿瘤相关抗体(TAA) 以评价TAA水平对预后的意义。 细胞介导的免疫活性测试将由白细胞进行 黑色素瘤提取液、淋巴母细胞黏附抑制试验 不同植物凝集素的转化和白细胞的直接迁移 在黑色素瘤提取物存在时的抑制作用。T淋巴细胞亚群将 通过玫瑰花结形成和商品化的单抗进行检测 抗体。将在新鲜的肿瘤组织中检查炎性细胞 使用单抗和组织化学技术。患有疾病的患者 葡萄膜黑色素瘤将接受组织相容性检查--HLA型 如果这些患者中某些人类白细胞抗原类型的发生率增加 与那些留下来的患者相比，谁会发生转移 没有肿瘤。最后，当时获得的眼液和肿瘤组织 将检查是否有肿瘤血管生成。 使用体内和体外技术的因子。这些技术将是 评估以寻找预后测试来检测这些患者将 会发展成转移瘤。

The biology of uveal malignant melanoma is complex. Recent conflicts in the literature have suggested that the standard enucleation technique may actually be disseminating tumor cells or reducing the patient's immunocompetence, causing metastatic disease. Because of this, some authors have gone so far as to suggest not enucleating a patient with uveal malignant melanoma. At the other extreme, some authors suggest the enucleation of every eye with a uveal melanoma, even if there is no detectable growth. This proposal will look at various immunological parameters in patients with uveal malignant melanoma presenting to the Wills Eye Hospital Oncology Service. The parameters to be studied include: tumor-associated antibodies (TAA) to cytoplasmic melanoma antigens in order to evaluate the prognostic significance of TAA levels. Cell-mediated immunocompetence testing will be performed by leukocyte adherence inhibition assay using melanoma extracts, lymphoblast transformation with various plant lectins, and direct leukocyte migration inhibition in the presence of melanoma extracts. T-lymphocyte subsets will be examined by rosette formation and commercially available monoclonal antibodies. Inflammatory cells will be examined in fresh tumor tissue using monoclonal antibodies and histo-chemical techniques. Patients with uveal melanoma will have their histo-compatability-HLA type examined to see if there are increased incidences of certain HLA types in those patients who develop metastases when compared to those patients who remain tumor-free. Finally, ocular fluids and tumor tissue obtained at the time of enucleation, will be examined for the presence of tumor angiogenesis factor using in vivo and in vitro techniques. These techniques will be evaluated to find prognostic tests for detecting these patients who will go on to develop metastases.