Boldt H Culver, Byrne Sandra Frazier, Gilson Marta Marsh, Finger Paul T, Green Ronald L, Straatsma Bradley R, Simpson E Rand, Hawkins Barbara S
Ophthalmology. 2008 Aug;115(8):1390-7, 1397.e1-2. doi: 10.1016/j.ophtha.2007.12.015. Epub 2008 Feb 11.
To report baseline echographic characteristics of tumors in patients enrolled in the Collaborative Ocular Melanoma Study (COMS) randomized trials, to determine how often these characteristics matched prespecified criteria for choroidal melanoma, to explore associations between echographic variables, and to compare specific echographic characteristics with pathologic characteristics of tumors in enucleated eyes.
Retrospective analyses of baseline data from multicenter randomized clinical trials.
Patients enrolled in the COMS large trial or medium tumor trials (N = 2320).
Standardized echography was used to document selected characteristics of tumors at baseline. Criteria were established to assess the consistency of echographic features with the diagnosis of melanoma. For eyes assigned to enucleation, the echographic diagnosis and evaluation for extraocular extension by the Echography Center were compared with gradings made by the Pathology Center and Pathology Review Committee.
Presence of various echographic and pathologic characteristics.
Two thousand forty-three tumors (88%) exhibited low to medium reflectivity (n = 1409), a mushroom shape (n = 101), or both (n = 533). Tumors with apical height > 10 mm were more likely (P<0.001) to have a mushroom shape and less likely to have a posterior location (P<0.001) than less elevated tumors. One thousand five hundred fifty-nine (99.7%) of 1563 tumors judged by echography to be consistent with the diagnosis of melanoma were confirmed by pathology to be choroidal melanoma. For measurable extrascleral tumors < 1.5 mm in height by pathology, the Echography Center graders judged extrascleral extension as possibly present in only 1 of 16 (6%) tumors, compared with 57% (4/7) of eyes with extrascleral extension measuring > or = 1.5 mm in height.
Eighty-eight percent of the tumors in the COMS exhibited features characteristic for melanoma: low to medium reflectivity, the classic mushroom shape, or both. Using additional preset criteria, 96% of tumors exhibited baseline echographic characteristics consistent with the diagnosis of melanoma. Echography graders were able to detect extrascleral nodules > or = 1.5 mm in elevation but not minimally elevated extraocular tumor extension. Clinicians and echographers can use these data to improve their understanding of the echographic features of untreated uveal melanomas.
报告参与协作性眼黑色素瘤研究（COMS）随机试验的患者肿瘤的基线超声特征，确定这些特征符合脉络膜黑色素瘤预设标准的频率，探索超声变量之间的关联，并将特定超声特征与摘除眼球中肿瘤的病理特征进行比较。
对多中心随机临床试验的基线数据进行回顾性分析。
参与COMS大型试验或中型肿瘤试验的患者（N = 2320）。
使用标准化超声记录基线时肿瘤的选定特征。建立标准以评估超声特征与黑色素瘤诊断的一致性。对于被指定进行眼球摘除的眼睛，将超声检查中心对眼球外扩展的超声诊断和评估与病理中心和病理审查委员会的分级进行比较。
各种超声和病理特征的存在情况。
2043个肿瘤（88%）表现出低至中等反射率（n = 1409）、蘑菇状（n = 101）或两者皆有（n = 533）。与高度较低的肿瘤相比，顶端高度> 10 mm的肿瘤更有可能呈蘑菇状（P<0.001），且位于后部位置的可能性更小（P<0.001）。经超声检查判断与黑色素瘤诊断一致的1563个肿瘤中，有1559个（99.7%）经病理证实为脉络膜黑色素瘤。对于病理检查高度< 1.5 mm的可测量巩膜外肿瘤，超声检查中心分级人员仅判断16个肿瘤中的1个（6%）可能存在巩膜外扩展，而对于巩膜外扩展高度≥ 1.5 mm的眼睛，这一比例为57%（4/7）。
COMS中88%的肿瘤表现出黑色素瘤的特征：低至中等反射率、经典蘑菇状或两者皆有。使用额外的预设标准，96%的肿瘤表现出与黑色素瘤诊断一致的基线超声特征。超声分级人员能够检测到高度≥ 1.5 mm的巩膜外结节，但无法检测到微小隆起的眼球外肿瘤扩展。临床医生和超声检查人员可以利用这些数据来增进对未经治疗的葡萄膜黑色素瘤超声特征的理解。
