葡萄膜黑色素瘤和视网膜组织相关性的病理学分析
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2015年北京市自然科学基金(No.7151003); 2013年度临床医学发展专项“杨帆”计划(No.ZYLX201307)


Histopathological analysis of the correlation between uveal melanomas and retinal tissue
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Natural Science Foundation of Beijing Municipality(No.7151003); Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(No.ZYLX201307)

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    摘要:

    目的:分析葡萄膜黑色素瘤的形状对视网膜结构的影响。

    方法:回顾性分析葡萄膜黑色素瘤患者的病理切片和临床资料,分析肿瘤形状、大小、高度-基底比值、视网膜薄变和浸润的差异。

    结果:本研究包括102例患者(102眼),平均年龄45.6±12.4岁。其中葡萄膜黑色素瘤76眼(75%)为梭形细胞型,6眼(6%)为上皮样细胞型,16眼(16%)为混合细胞型,其它4眼(4%)。按肿瘤部位分:睫状体黑色素瘤3眼(2.9%),睫状体和脉络膜黑色素瘤28眼(27.5%),脉络膜黑色素瘤71眼(69.6%)。视网膜组织的分析中,43眼(43%)发现视网膜变薄,86眼(84%)发现视网膜浸润。肿瘤的高度在1.2~15.6(平均8.3±3.6)mm,肿瘤基底直径为4.8~31.2(平均17.3±6.5)mm。肿瘤峰高度-基底R值为0.53±0.32。视网膜薄变组(n=43)的平均R值显着高于无视网膜薄变组(n=59)(0.69±0.31与0.42±0.27; P<0.01)。视网膜肿瘤浸润组(n=86)的平均R值比无视网膜浸润组(n=16)略高(0.56±0.33比0.41±0.25; P=0.09),但无统计学意义。

    结论:高R值的肿瘤与其邻近视网膜薄变有关,与视网膜内肿瘤细胞浸润相关性不大。葡萄膜黑色素瘤的切面形状和邻近视网膜组织的受累情况关系紧密。

    Abstract:

    AIM: To analyze the impacts of the shape of uveal melanoma on retinal structure.

    METHODS: Histopathological sections and clinical data from patients with uveal melanoma were retrospectively observed and analyzed, and key indicators including the tumor's shape, size, height-to-base ratio, retinal thinning and retinal invasion were analyzed.

    RESULTS: The study included 102 patients(102 eyes)with a mean age of 45.6±12.4 years, with 76(75%)uveal melanomas showing the spindle cell type, 6(6%)showing the epitheloid cell type, 16(16%)showing the mixed cell type and 4(4%)showing predominantly other cell types. Differentiated by tumor locations: 3 cases of ciliary body melanoma(2.9%), 28 cases of ciliary body and choroid melanoma(27.5%), 71 cases of choroid melanoma(69.6%). Retinal thinning was detected in 43(43%)eyes and retinal invasion by the tumor cells in 86(84%)eyes. Maximal tumor height ranged between 1.2 and 15.6(mean: 8.3±3.6)mm, and mean maximal tumor base diameter was 17.3±6.5(range: 4.8-31.2)mm. Mean R-value as ratio of tumor peak height to maximal tumor base diameter was 0.53±0.32. Mean R-value was significantly higher in the group with retinal thinning(n=43)than in the group without retinal thinning(n=59)(0.69±0.31 vs 0.42±0.27; P<0.01). R-value was slightly, however statistically not significantly higher in the group with retinal tumor invasion(n=86)than without retinal tumor invasion(n=16)(0.56±0.33 vs 0.41±0.25; P=0.09).

    CONCLUSION: A high R-value indicating a prominent tumor is associated with tissue thinning in the adjacent retina, and marginally significantly with intra-retinal tumor cell invasion. Shape of uveal melanomas's corss section is of importance for the secondary involvement of the adjacent retina.

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张举,魏文斌,李彬,顼晓琳,Jonas JB.葡萄膜黑色素瘤和视网膜组织相关性的病理学分析.国际眼科杂志 2020;20(2):197-202,DOI:10.3980/j. issn.1672-5123.2020.2.02

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  • 收稿日期:2019-01-03
  • 最后修改日期:2020-01-03
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  • 在线发布日期: 2020-01-19
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