3334 例连续患者种族相关脉络膜黑色素瘤恶变。
Malignant transformation of choroidal nevus according to race in 3334 consecutive patients.
机构信息
Department of Ophthalmology, Ocular Oncology Service, Wills Eye Hospital, Jefferson University, Philadelphia, PA, USA.
Department of Ophthalmology, Ocular Oncology Service, Wills Eye Hospital, Jefferson University, Philadelphia, PA; Department of Ophthalmology, Ocular Oncology Service, Mayo Clinic, Rochester, MN, USA.
出版信息
Indian J Ophthalmol. 2019 Dec;67(12):2035-2042. doi: 10.4103/ijo.IJO_1217_19.
PURPOSE
To evaluate choroidal nevus demographics, clinical features, imaging features, and the rate of transformation into melanoma by race.
METHODS
IN THIS OBSERVATIONAL CASE SERIES,: There were 3334 participants (3806 choroidal nevi) at a single tertiary-referral center evaluated between January 2, 2007, and August 7, 2017. Retrospective chart and multimodal imaging review was performed. Patient demographics, tumor features, and outcomes were compared between different races using Chi-squared test, Fisher's exact test, t-test, and analysis of variance. The main outcome measure was clinical features of choroidal nevus and the rate of transformation into melanoma by race.
RESULTS
Of the 3334 patients, there were Caucasian (n = 3167, 95%) and non-Caucasian (n = 167, 5%). The non-Caucasian races included African-American (n = 27, <1%), Hispanic (n = 38, <1%), Asian (n = 15, <1%), Asian Indian (n = 2, <1%), Middle Eastern (n = 4, <1%), and unknown (n = 83, 3%). By comparison (Caucasian versus vs. non-Caucasian), there were differences in the mean age at presentation (61 vs. 56 years,P < 0.0001), female sex (63% vs. 52%,P < 0.01), dysplastic nevus syndrome (<1% vs. 1%,P < 0.01), and previous cutaneous melanoma (5% vs. 1%,P= 0.03). A comparison of tumor features revealed differences in presence of symptoms (12% vs. 20%,P < 0.01) and ≥3 nevi per eye (3% vs. <1%,P= 0.04). A comparison of imaging features showed no differences. A comparison of outcome of nevus transformation into melanoma revealed no difference (2% vs. 3%,P= 0.29). However, of those nevi exhibiting growth to melanoma, ultrasonographic hollowness was less frequent in Caucasians (29% vs. 67%,P= 0.04).
CONCLUSION
In this analysis of 3334 patients with choroidal nevus, we found differences in the mean age of presentation, sex, dysplastic nevus syndrome, previous cutaneous melanoma, presence of symptoms, and multiplicity of nevus per eye by race. However, there was no difference in the rate of transformation into melanoma by race.
目的
评估种族因素对脉络膜痣的人口统计学、临床特征、影像学特征和向黑色素瘤转化的影响。
方法
本研究为单中心回顾性观察性病例系列研究，纳入 2007 年 1 月 2 日至 2017 年 8 月 7 日期间在一家三级转诊中心接受治疗的 3334 名（3806 个）患者。进行了病历和多模态成像回顾。采用卡方检验、Fisher 确切检验、t 检验和方差分析比较不同种族之间的患者人口统计学特征、肿瘤特征和结局。主要结局指标为脉络膜痣的临床特征和种族因素导致黑色素瘤转化的发生率。
结果
在 3334 名患者中，有 3167 名（95%）为白种人，167 名（5%）为非白种人。非白种人包括非洲裔美国人（27 名，<1%）、西班牙裔（38 名，<1%）、亚洲人（15 名，<1%）、亚洲印度人（2 名，<1%）、中东人（4 名，<1%）和未知种族（83 名，3%）。与白种人相比，非白种人患者的平均发病年龄（61 岁 vs. 56 岁，P<0.0001）、女性（63% vs. 52%，P<0.01）、发育不良痣综合征（<1% vs. 1%，P<0.01）和既往皮肤黑色素瘤（5% vs. 1%，P=0.03）存在差异。肿瘤特征比较显示，有症状的患者比例（12% vs. 20%，P<0.01）和每只眼≥3 个痣的比例（3% vs. <1%，P=0.04）存在差异。影像学特征的比较无差异。黑色素瘤转化为黑色素瘤的结果比较无差异（2% vs. 3%，P=0.29）。然而，在表现出生长为黑色素瘤的痣中，白人患者的超声空洞表现较少（29% vs. 67%，P=0.04）。
结论
在对 3334 名脉络膜痣患者的分析中，我们发现种族因素与平均发病年龄、性别、发育不良痣综合征、既往皮肤黑色素瘤、症状存在以及每只眼痣的数量有关。然而，种族对黑色素瘤转化的影响没有差异。
Zotero 插件