Saornil M A, Egan K M, Gragoudas E S, Seddon J M, Walsh S M, Albert D M
Eye Pathology Laboratory, Massachusetts Eye and Ear Infirmary, Boston 02114.
Arch Ophthalmol. 1992 Aug;110(8):1112-8. doi: 10.1001/archopht.1992.01080200092031.
The histopathology of eyes with uveal melanoma was compared in a masked fashion in 47 eyes whose primary treatment was enucleation and a matched series of 47 eyes enucleated after proton beam irradiation. Irradiated tumors were more likely to show signs of necrosis (P less than .001) and fibrosis (P = .005) and to have balloon cells present (P = .002). In the irradiated group, mitotic figures were fewer in 40 high-power fields (P = .020), and the prevalence of tumor blood vessel damage (P less than .001) was higher. Changes in the retina were more common in the irradiated series, but damage was usually overlying or in close proximity to the tumor. Based on characteristic changes, the pathologist distinguished irradiated from nonirradiated eyes in 85% of the cases. These findings suggest that irradiation damages tumor cells and blood vessels, and alters the tumor's capacity for cellular reproduction.
对47例接受眼球摘除术作为主要治疗方式的葡萄膜黑色素瘤患眼以及47例质子束照射后接受眼球摘除术的配对患眼进行了组织病理学的盲法比较。接受照射的肿瘤更有可能出现坏死迹象（P<0.001）和纤维化（P=0.005），并且存在气球样细胞（P=0.002）。在接受照射的组中，40个高倍视野中的有丝分裂象较少（P=0.020），肿瘤血管损伤的发生率较高（P<0.001）。视网膜改变在接受照射的系列中更为常见，但损伤通常位于肿瘤上方或紧邻肿瘤。基于特征性改变，病理学家在85%的病例中区分出了接受照射和未接受照射的患眼。这些发现表明，照射会损伤肿瘤细胞和血管，并改变肿瘤的细胞增殖能力。
