后部葡萄膜黑色素瘤活检及其临床意义的研究

doi:10.6040/j.issn.1673-3770.0.2021.570

摘要/Abstract

摘要： 后部葡萄膜黑色素瘤(PUMs)是一种最常见的成人眼内原发恶性肿瘤,早期起病隐匿,无典型症状,国内外对于PUMs患者的诊断多以临床特征为依据,容易漏诊或误诊。近年来肿瘤学者对于PUMs患者的确诊(国外确诊也主要依据临床特征,活检主要用于判断预后和进一步研究)常用细针穿刺活检(FNAB)和玻璃体视网膜脉络膜活检(TVRC)两种活检方式。目前关于FNAB、TVRC用于确诊PUMs患者的系统性总结研究较少,故本文就两种活检方式用于PUMs患者确诊时的临床安全性、取样方法、临床意义等展开综述。

关键词: 后部葡萄膜黑色素瘤, 细针穿刺活检, 玻璃体视网膜脉络膜活检, 安全性:临床意义

Abstract: Posterior uveal melanoma(PUMs), the most common primary intraocular malignant tumor in adults, typically has an early onset that is insidious and asymptomatic. The diagnosis of patients with PUMs at home and abroad is primarily based on clinical features, which are easily missed or misdiagnosed. In recent years, oncologists have commonly used two types of biopsies to confirm the diagnosis of patients with PUMs: fine-needle aspiration biopsy(FNAB)and transvitreal retinochoroidal biopsy(TVRC). At present, there are few systematic studies on the application of FNAB and TVRC in the diagnosis of PUM. This paper reviews the clinical safety, sampling methods, and clinical significance of these two biopsy methods in the diagnosis of PUM.

Key words: Posterior uveal melanomas, Fine-needle aspiration biopsy, Transvitreal retinochoroidal biopsy, Security, Clinical significance

中图分类号:

R779.62

孙浩, 杨会,李姣. 后部葡萄膜黑色素瘤活检及其临床意义的研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 152-156.

SUN Hao, YANG Hui, LI Jiao. Study on the clinical significance of posterior uveal melanoma biopsy[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 152-156.

参考文献

[1] 蒋梦婷, 王海青. 葡萄膜黑色素瘤的放疗方法及其并发症的临床研究进展[J]. 西南国防医药, 2020, 30(1): 79-81. doi:10.3969/j.issn.1004-0188.2020.01.032 JIANG Mengting, WANG Haiqing. Clinical research progress of radiotherapy methods and complications of uveal melanoma[J]. Medical Journal of National Defending Forces in Southwest China, 2020, 30(1): 79-81. doi:10.3969/j.issn.1004-0188.2020.01.032
[2] Koopmans AE, Verdijk RM, Brouwer RW, et al. Clinical significance of immunohistochemistry for detection of BAP1 mutations in uveal melanoma[J]. Mod Pathol, 2014, 27(10): 1321-1330. doi:10.1038/modpathol.2014.43
[3] Gass JD. Problems in the differential diagnosis of choroidal nevi and malignant melanoma. XXXIII Edward Jackson Memorial lecture[J]. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol, 1977, 83(1): 19-48. doi: 10.1089/ten.2005.11.1254
[4] 王依凝, 魏文斌. 葡萄膜黑色素瘤的预后评估[J]. 中国医学前沿杂志(电子版), 2020, 12(12): 11-17. doi:10.12037/YXQY.2020.12-03 WANG Yining, WEI Wenbin. Prognostic evaluation of uveal melanoma[J]. Chinese Journal of the Frontiers of Medical Science(Electronic Version), 2020, 12(12): 11-17. doi:10.12037/YXQY.2020.12-03
[5] Fry MV, Augsburger JJ, Corrêa ZM. Clinical features, metastasis, and survival in patients younger than 21 years with posterior uveal melanoma[J]. JAMA Ophthalmol, 2019, 137(1): 75-81. doi:10.1001/jamaophthalmol.2018.5132
[6] 魏文斌, 屠颖. 眼内肿瘤细针穿刺活检的利与弊[J]. 眼科, 2012, 21(4): 217-221. WEI Wenbin, TU Ying. Pros and cons of fine needle aspiration biopsy in ocular tumors[J]. Petroleum Exploration and Development, 2012, 21(4): 217-221.
[7] Singh AD, Medina CA, Singh N, et al. Fine-needle aspiration biopsy of uveal melanoma: outcomes and complications[J]. Br J Ophthalmol, 2016, 100(4): 456-462. doi:10.1136/bjophthalmol-2015-306921
[8] Finn AP, Materin MA, Mruthyunjaya P. CHOROIDAL TUMOR BIOPSY: a review of the current state and a glance into future techniques[J]. Retina, 2018, 38(1): S79-S87. doi:10.1097/IAE.0000000000001997
[9] 蔡国平. 细针穿刺活检在葡萄膜黑色素瘤诊断和预后评估中的应用[J]. 中华眼视光学与视觉科学杂志, 2020, 22(2): 81-86. doi:10.3760/cma.j.issn.1674-845X.2020.02.001 CAI Guoping. Diagnosis and prognostic evaluation of uveal melanoma via fine needle aspiration biopsy[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2020, 22(2): 81-86. doi:10.3760/cma.j.issn.1674-845X.2020.02.001
[10] Shields CL, Materin MA, Teixeira L, et al. Small choroidal melanoma with chromosome 3 monosomy on fine-needle aspiration biopsy[J]. Ophthalmology, 2007, 114(10): 1919-1924. doi:10.1016/j.ophtha.2007.04.054
[11] McCannel TA, Chang MY, Burgess BL. Multi-year follow-up of fine-needle aspiration biopsy in choroidal melanoma[J]. Ophthalmology, 2012, 119(3): 606-610. doi:10.1016/j.ophtha.2011.08.046
[12] Corrêa ZM, Augsburger JJ. Indications for fine needle aspiration biopsy of posterior segment intraocular tumors[J]. Am J Ophthalmol, 2019, 207: 45-61. doi:10.1016/j.ajo.2019.05.018
[13] Eide N, Walaas L. Fine-needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a review[J]. Acta Ophthalmol, 2009, 87(6): 588-601. doi:10.1111/j.1755-3768.2009.01637.x
[14] Midena E, Bonaldi L, Parrozzani R, et al. In vivo detection of monosomy 3 in eyes with medium-sized uveal melanoma using transscleral fine needle aspiration biopsy[J]. Eur J Ophthalmol, 2006, 16(3): 422-425. doi:10.1177/112067210601600310
[15] Eide N, Syrdalen P, Walaas L, et al. Fine needle aspiration biopsy in selecting treatment for inconclusive intraocular disease[J]. Acta Ophthalmol Scand, 1999, 77(4): 448-452. doi:10.1034/j.1600-0420.1999.770419.x
[16] Shields CL, Ganguly A, Materin MA, et al. Chromosome 3 analysis of uveal melanoma using fine-needle aspiration biopsy at the time of plaque radiotherapy in 140 consecutive cases[J]. Trans Am Ophthalmol Soc, 2007, 105: 43-52. doi: 10.1001/archopht.125.8.1017
[17] Abi-Ayad N, Grange JD, Salle M, et al. Transretinal uveal melanoma biopsy with 25-gauge vitrectomy system[J]. Acta Ophthalmol, 2013, 91(3): 279-281. doi:10.1111/j.1755-3768.2011.02172.x
[18] Reddy DM, Mason LB, Mason JO III, et al. Vitrectomy and vitrector port needle biopsy of choroidal melanoma for gene expression profile testing immediately before brachytherapy[J]. Ophthalmology, 2017, 124(9): 1377-1382. doi:10.1016/j.ophtha.2017.03.053
[19] Sellam A, Desjardins L, Barnhill R, et al. Fine needle aspiration biopsy in uveal melanoma: technique, complications, and outcomes[J]. Am J Ophthalmol, 2016, 162: 28-34.e1. doi:10.1016/j.ajo.2015.11.005
[20] Eide N, Walaas L. Fine-needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a review[J]. Acta Ophthalmol, 2009, 87(6): 588-601. doi:10.1111/j.1755-3768.2009.01637.x
[21] Bagger M, Tebering JF, Kiilgaard JF. The ocular consequences and applicability of minimally invasive 25-gauge transvitreal retinochoroidal biopsy[J]. Ophthalmology, 2013, 120(12): 2565-2572. doi:10.1016/j.ophtha.2013.07.043
[22] Abi-Ayad N, Grange JD, Salle M, et al. Transretinal uveal melanoma biopsy with 25-gauge vitrectomy system[J]. Acta Ophthalmol, 2013, 91(3): 279-281. doi:10.1111/j.1755-3768.2011.02172.x
[23] Grewal DS, Cummings TJ, Mruthyunjaya P. Outcomes of 27-gauge vitrectomy-assisted choroidal and subretinal biopsy[J]. Ophthalmic Surg Lasers Imaging Retina, 2017, 48(5): 406-415. doi:10.3928/23258160-20170428-07
[24] Tang PH, Shields RA, Schefler AC, et al. Biopsy of a choroidal melanoma using transvitreal pars Plana vitrectomy[J]. Ophthalmic Surg Lasers Imaging Retina, 2018, 49(8): 645-647. doi:10.3928/23258160-20180803-16.
[25] Finn AP, Materin MA, Mruthyunjaya P. CHOROIDAL TUMOR BIOPSY: a review of the current state and a glance into future techniques[J]. Retina, 2018, 38(1): 79-87. doi:10.1097/IAE.0000000000001997
[26] Hussain RN, Kalirai H, Groenewald C, et al. Prognostic biopsy of choroidal melanoma after proton beam radiation therapy[J]. Ophthalmology, 2016, 123(10): 2264-2265. doi:10.1016/j.ophtha.2016.05.028
[27] Augsburger JJ, Corrêa ZM, Schneider S, et al. Diagnostic transvitreal fine-needle aspiration biopsy of small melanocytic choroidal tumors in nevus versus melanoma category[J]. Trans Am Ophthalmol Soc, 2002, 100: 225-232.
[28] Bagger M, Smidt-Nielsen I, Andersen MK, et al. Long-term metastatic risk after biopsy of posterior uveal melanoma[J]. Ophthalmology, 2018, 125(12): 1969-1976. doi:10.1016/j.ophtha.2018.03.047
[29] 张瑞恒, 李洋, 魏文斌. 葡萄膜黑色素瘤分子预后指标的研究进展[J]. 中国医学前沿杂志(电子版), 2020, 12(12): 4-10. doi:10.12037/YXQY.2020.12-02 ZHANG Ruiheng, LI Yang, WEI Wenbin. Molecular prognosis factors of uveal melanoma: history and current progress[J]. Chinese Journal of the Frontiers of Medical Science(Electronic Version), 2020, 12(12): 4-10. doi:10.12037/YXQY.2020.12-02
[30] McCannel TA. Fine-needle aspiration biopsy in the management of choroidal melanoma[J]. Curr Opin Ophthalmol, 2013, 24(3): 262-266. doi:10.1097/ICU.0b013e32835ff001
[31] Correa ZM, Augsburger JJ. Sufficiency of FNAB aspirates of posterior uveal melanoma for cytologic versus GEP classification in 159 patients, and relative prognostic significance of these classifications[J]. Graefes Arch Clin Exp Ophthalmol, 2014, 252(1): 131-135. doi:10.1007/s00417-013-2515-0
[32] 向中正, 刘磊. 葡萄膜黑色素瘤诊疗进展[J]. 华西医学, 2018, 33(11): 1433-1440. doi: 10.7507/1002-0179.201810077 XIANG Zhongzheng, LIU Lei. Progress in diagnosis and treatment of uveal melanoma[J]. West China Medical Journal, 2018, 33(11): 1433-1440. doi: 10.7507/1002-0179.201810077
[33] Field MG, Decatur CL, Kurtenbach S, et al. PRAME as an independent biomarker for metastasis in uveal melanoma[J]. Clin Cancer Res, 2016, 22(5): 1234-1242. doi:10.1158/1078-0432.CCR-15-2071
[34] Field MG, Durante MA, Decatur CL, et al. Epigenetic reprogramming and aberrant expression of PRAME are associated with increased metastatic risk in Class 1 and Class 2 uveal melanomas[J]. Oncotarget, 2016, 7(37): 59209-59219. doi:10.18632/oncotarget.10962
[35] Yang J, Manson DK, Marr BP, et al. Treatment of uveal melanoma: where are we now? [J]. Ther Adv Med Oncol, 2018, 10: 1758834018757175. doi:10.1177/1758834018757175

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