Callejo S A, Antecka E, Blanco P L, Edelstein C, Burnier M N
Henry C Witelson Ophthalmic Pathology Laboratory and Registry, McGill University Health Center, Montreal, Quebec, Canada.
Eye (Lond). 2007 Jun;21(6):752-9. doi: 10.1038/sj.eye.6702322. Epub 2006 Mar 31.
Most uveal melanoma patients (UMP) do not show evidence of metastases upon diagnosis. However, despite local tumour control, approximately 50% of them will develop metastases. These findings suggest that malignant cells may have already disseminated by the time of initial diagnosis. The purpose of the study was to detect circulating malignant cells (CMCs) in UMP and to correlate them with prognostic factors and therapy.
Nested reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect CMCs. In each UMP, blood was collected every 3 months. In each visit, 20 RT-PCR tests were performed. The date of diagnosis, largest tumour dimension, type, and date of treatment were obtained.
A total of 30 UMP were enrolled. Five patients were enrolled at the time of diagnosis and 25 patients between 1 and 17 years following diagnosis. No UMP showed clinical evidence of metastasis. A total of 136 visits were registered, 1360 samples collected, and 2720 RT-PCRs performed. CMCs were identified in 29 patients in 119 visits (87.5%). However, in each visit, a low number of positive tests were recorded. CMCs were found in newly diagnosed, irradiated, enucleated, and observed patients regardless of tumour size and time period following treatment.
Uveal melanoma (UM) is not a localized ocular disease. CMCs were recorded at initial diagnosis confirming the early metastatic nature of UM. CMCs were present following treatment, including enucleation, demonstrating that CMCs are capable of disseminating and surviving, possibly as micrometastasis, which would contribute to the pool of CMCs at a later stage. Systemic therapy should be evaluated.
大多数葡萄膜黑色素瘤患者（UMP）在诊断时并无转移迹象。然而，尽管肿瘤得到了局部控制，但其中约50%的患者仍会发生转移。这些发现表明，恶性细胞可能在初次诊断时就已发生播散。本研究的目的是检测UMP患者循环中的恶性细胞（CMC），并将其与预后因素及治疗相关联。
采用巢式逆转录聚合酶链反应（RT-PCR）检测CMC。在每位UMP患者中，每3个月采集一次血液。每次就诊时进行20次RT-PCR检测。获取诊断日期、最大肿瘤尺寸、类型及治疗日期。
共纳入30例UMP患者。5例患者在诊断时纳入，25例患者在诊断后1至17年纳入。所有UMP患者均无转移的临床证据。共记录136次就诊，采集1360份样本，进行2720次RT-PCR检测。在119次就诊的29例患者中检测到CMC（87.5%）。然而，每次就诊时记录的阳性检测数量较少。无论肿瘤大小及治疗后的时间段如何，在新诊断、接受放疗、眼球摘除及观察的患者中均发现了CMC。
葡萄膜黑色素瘤（UM）并非局限性眼部疾病。在初次诊断时就检测到了CMC，证实了UM的早期转移特性。在包括眼球摘除在内的治疗后仍存在CMC，表明CMC能够播散并存活，可能以微转移的形式存在，这将在后期增加CMC的数量。应评估全身治疗。
