Coleman D J, Silverman R H, Rondeau M J, Lizzi F L, McLean I W, Jakobiec F A
Department of Ophthalmology, Cornell University Medical College, New York, NY 10021.
Am J Ophthalmol. 1990 Oct 15;110(4):380-8. doi: 10.1016/s0002-9394(14)77018-7.
Forty-six eyes with uveal melanoma were scanned with a computerized diagnostic ultrasound system before enucleation, and light microscope sections were obtained. Tumors were characterized by ultrasonically measured dimensions and power spectrum analysis, which provided information not available in conventional A- or B-scan ultrasonography. Histopathologic features, including cell clustering pattern, cell type, pigmentation, vascularity, and necrosis, were quantified. Statistically significant correlations were found between parameters derived from the power spectrum and histologic characteristics. Patients were followed up for up to ten years with 14 deaths occurring because of metastases. Using a Cox relative risk model with histopathologic data, a risk model comprising pigmentation and cell type (P less than .0001) was obtained. Using ultrasonic characteristics, a model comprising tumor volume and scatterer concentration (P = .0062) was obtained. The results suggest that ultrasonic tissue characterization and three-dimensional biometry may provide improved in vivo prognostic indicators for uveal melanoma.
46只患有葡萄膜黑色素瘤的眼睛在眼球摘除术前用计算机诊断超声系统进行了扫描，并获取了光镜切片。通过超声测量肿瘤尺寸和功率谱分析对肿瘤进行特征描述，这提供了传统A超或B超超声检查无法获得的信息。对组织病理学特征进行了量化，包括细胞聚集模式（cell clustering pattern）、细胞类型、色素沉着、血管形成和坏死。发现功率谱参数与组织学特征之间存在统计学上的显著相关性。对患者进行了长达十年的随访，有14例因转移而死亡。使用包含组织病理学数据的Cox相对风险模型，获得了一个由色素沉着和细胞类型组成的风险模型（P<0.0001）。使用超声特征，获得了一个由肿瘤体积和散射体浓度组成的模型（P = 0.0062）。结果表明，超声组织特征分析和三维生物测量可能为葡萄膜黑色素瘤提供更好的体内预后指标。
