Department of Ophthalmology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
Invest Ophthalmol Vis Sci. 2010 Feb;51(2):658-65. doi: 10.1167/iovs.09-3824. Epub 2009 Sep 24.
Invasion of tumor cells into blood vessels is essential for metastasis of uveal melanoma. The occurrence of ingrowth of tumor cells in blood vessels in uveal melanoma was analyzed, and this parameter was compared with the survival of the patients.
Between 1972 and 2007, 643 eyes primarily enucleated for uveal melanoma were evaluated histopathologically. Survival data were obtained from charts and from the Integral Cancer Center patient registry.
No vascular ingrowth of tumor cells occurred in 59% of the eyes, whereas 18% had tumor cell ingrowth in vessels inside the tumor, 10% in vessels outside the tumor, and 8% in vessels inside as well as outside the tumor. The presence of any intravascular ingrowth of tumor cells correlated significantly with the diameter (P < 0.01) and prominence of the tumor (P < 0.01), as well as with non-spindle-cell type (P = 0.03) and intrascleral ingrowth (P < 0.01), and was associated with a worse survival. When extravascular matrix patterns were not included in the multivariate analysis, intravascular ingrowth came out as an independent prognostic factor, but this was not the case when extravascular matrix patterns were included in the multivariate model.
Intravascular ingrowth of tumor cells in uveal melanoma occurs frequently in combination with well-known histopathologic factors such as large tumor size, epithelioid cell type, and intrascleral ingrowth.
肿瘤细胞侵入血管对于葡萄膜黑色素瘤的转移是必不可少的。分析了葡萄膜黑色素瘤中肿瘤细胞在血管内生长的发生情况，并将该参数与患者的生存情况进行了比较。
1972 年至 2007 年间，对 643 只因葡萄膜黑色素瘤而首次行眼球摘除的眼睛进行了组织病理学评估。生存数据来自图表和综合癌症中心患者登记处。
59%的眼睛中未发生肿瘤细胞的血管内生长，而 18%的眼睛中有肿瘤细胞在肿瘤内血管中生长，10%的眼睛中有肿瘤细胞在肿瘤外血管中生长，8%的眼睛中有肿瘤细胞在肿瘤内和外血管中生长。任何血管内肿瘤细胞生长的存在与肿瘤的直径（P<0.01）和突出度（P<0.01）显著相关，与非纺锤形细胞类型（P=0.03）和巩膜内生长（P<0.01）相关，与较差的生存相关。当血管外基质模式不包括在多变量分析中时，血管内生长是一个独立的预后因素，但当血管外基质模式包括在多变量模型中时，情况并非如此。
葡萄膜黑色素瘤中肿瘤细胞的血管内生长常与大肿瘤大小、上皮样细胞类型和巩膜内生长等已知的组织病理学因素相结合。
