Nagiel Aaron, McCannel Colin A, Moreno Christian, McCannel Tara A
*Retina Division, Stein Eye Institute, University of California Los Angeles, Los Angeles, California; and †Department of Ophthalmology, Doheny Eye Institute, Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.
Retina. 2017 Jul;37(7):1377-1382. doi: 10.1097/IAE.0000000000001362.
Fine-needle aspiration biopsy of small choroidal melanomas 2 mm or less in thickness may be associated with a low biopsy yield. This report describes our center's experience using the 27-gauge vitreous cutter to perform tumor sampling in these small melanomas.
This was a retrospective analysis of all patients who underwent a 27-gauge vitreous cutter biopsy for molecular prognostication at the time of iodine-125 plaque placement for local treatment of choroidal melanoma ≤2.0 mm in height.
Seventeen consecutive patients with a mean baseline tumor height of 1.67 mm (range, 1.31-2.03 mm) and median follow-up time of 7.0 months (range, 3.3-19.5 months) were included. The 27-gauge cutter biopsy yielded sufficient material for multiplex-ligation probe amplification (MLPA) or gene expression profiling (GEP) in 17/17 (100%) patients. Complications were limited to focal vitreous hemorrhage in 13/17 patients and diffuse vitreous hemorrhage in 1/17 patients, with no instance of retinal detachment or nonclearing vitreous hemorrhage.
Tumor sampling of small choroidal melanoma with a 27-gauge vitreous cutter is safe and offers excellent biopsy yield for molecular prognostication when cancer prognosis is desired by patients.
对厚度在2毫米及以下的小脉络膜黑色素瘤进行细针穿刺活检，活检阳性率可能较低。本报告介绍了我们中心使用27G玻璃体切割器对这些小黑色素瘤进行肿瘤取样的经验。
这是一项回顾性分析，纳入了所有在接受碘-125敷贴局部治疗高度≤2.0毫米的脉络膜黑色素瘤时，使用27G玻璃体切割器进行活检以进行分子预后评估的患者。
连续纳入17例患者，平均基线肿瘤高度为1.67毫米（范围1.31 - 2.03毫米），中位随访时间为7.0个月（范围3.3 - 19.5个月）。27G切割器活检在17/17（100%）的患者中获得了足够用于多重连接探针扩增（MLPA）或基因表达谱分析（GEP）的材料。并发症仅限于13/17的患者出现局灶性玻璃体出血，1/17的患者出现弥漫性玻璃体出血，未发生视网膜脱离或玻璃体出血不吸收的情况。
使用27G玻璃体切割器对小脉络膜黑色素瘤进行肿瘤取样是安全的，并且当患者需要了解癌症预后时，可为分子预后评估提供出色的活检阳性率。
