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葡萄膜黑色素瘤的细针抽吸活检:技术、并发症和结果

Sellam A, Desjardins L, Barnhill R

期刊名称:AJO 美国眼科学杂志

卷期:第161-2卷(2016年)2期

关键词:

摘要

 目的:报告葡萄膜黑色素瘤的细针抽吸活检:技术、并发症和结果。

设计:回顾性队列研究
方法:细针穿刺活检(FNAB)
结果:对在眼肿瘤中心接受经巩膜或经玻璃体的细针穿刺的葡萄膜黑色素瘤患者的回顾性评估。对厚度超过5mm的肿瘤进行细针抽吸活检。对有足够组织的活检样品进行对队列比较基因组杂交分析。主要成果的衡量指标,成功率(符合生物标志物分析结果的样本),并发症,肝转移,和总存活数.结果:对平均年龄为56.7的( 16-84岁)217位患者(114男性,52%)进行连续研究。平均随访时间为31(范围3.6-61.3)个月。平均肿瘤厚度为8.4(范围5-12)毫米。该过程的总体成功率为169例(77.9%)。31例患者(14.3%)出现了玻璃体出血,其中9例患者(4.1%)需要手术治疗玻璃体。并未出现眼内炎,眶传播,局部复发或孔源性视网膜脱离的情况。 在本研究中,32例患者(14.7%)在研究过程中发现远端转移,其中20(9.2%)例死亡。 在169例成功研究对象中,53名患者(31%)被归类为低风险,41(24%)名患者被归类为中度风险,和54(32%)名患者被归类为高风险。 15例患者(9%)未检测出任何的染色体异常,6名(4%)无法归类。
结论:细针抽吸活检术FNAB是可常规用于获得组织从而进行分子基因组分析的,相对安全的和成功的技术。这样的分析可帮助确定葡萄膜黑色素瘤的诊断和预后。
PURPOSE:To report the technical aspects, complications, and outcomes concerning fine needle aspiration biopsy (FNAB) in uveal melanoma.
DESIGN:Retrospective cohort study.
METHODS:Patients with uveal melanoma who underwent transscleral or transvitreal FNAB at an ocular oncology center were retrospectively evaluated. FNAB was performed if the tumor was more than 5mm in thickness. Array comparative genomic hybridization analysis was performed on biopsy samples with sufficient tissue. The main outcome measures were success (sample that gave a successful result for biomarker analysis) rate, complications, liver metastasis, and overall survival.RESULTS:There were 217 (114 male, 52%) consecutive study patients with a mean age of 56.7 (16-84) years. The mean follow-up period was 31 (range 3.6-61.3) months. Mean tumor thickness was 8.4 (range 5-12) mm. The overall success rate of the procedure was 169 patients (77.9%). Thirty-one patients (14.3%) experienced intravitreal hemorrhage, of whom 9 (4.1%) required vitreal surgery. There was no case of endophthalmitis, orbital dissemination, local recurrence, or rhegmatogenous retinal detachment. Thirty-two patients (14.7%) developed metastasis during the study, of whom 20 (9.2%) died. Of the 169 successful samples, 53 patients (31%) were classified as low risk, 41 (24%) as intermediate risk, and 54 (32%) as high risk. Fifteen patients (9%) did not have any detectable chromosomal abnormality and 6 (4%) could not be classified.
CONCLUSION:FNAB is a relatively safe and successful technique that can be routinely used to obtain tissue for molecular genomic analysis; such analysis helps determine the diagnosis and prognosis in uveal melanoma.
 

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