Donoso L A, Augsburger J J, Shields J A, Greenberg R A, Gamel J
Arch Ophthalmol. 1986 Jan;104(1):76-8. doi: 10.1001/archopht.1986.01050130086026.
The length of survival time following enucleation was determined for 29 patients with primary malignant melanoma of the choroid and ciliary body who subsequently died of metastatic disease. Histologic sections of the 29 tumors were studied by standard light microscopic techniques and computerized morphometry. The largest diameter of each tumor was measured on the 37% formaldehyde-fixed, paraffin-embedded slides; a cell type was assigned to each tumor on the basis of histologic study, using the modified Callender cell-type classification system; and inverse standard deviation of the nucleolar area (ISDNA) was determined for each tumor by computerized morphometric analysis. The observed death-order of these patients was then compared with the death-order predicted by ranking cases in ascending order of age at treatment, size of tumor, cell type, and ISDNA. Using rank-order correlation coefficient tests, only the correlation between ISDNA rank-order and observed death-order was found to be statistically significant. We believe that the limitations of the modified Callender cell-type classification system in predicting length of survival time following enucleation are related to the relatively few categories (four) in which to classify tumors, whereas the ISDNA represents a continuous spectrum of unlimited categories. As such, ISDNA can be more discriminant in selecting tumors of high malignant potential.
对29例脉络膜和睫状体原发性恶性黑色素瘤患者进行了眼球摘除术后生存时间的测定，这些患者随后死于转移性疾病。采用标准光学显微镜技术和计算机形态测量法对这29例肿瘤的组织学切片进行了研究。在37%甲醛固定、石蜡包埋的切片上测量每个肿瘤的最大直径；根据组织学研究，使用改良的卡伦德细胞类型分类系统为每个肿瘤确定细胞类型；通过计算机形态测量分析确定每个肿瘤的核仁面积反标准差（ISDNA）。然后将这些患者观察到的死亡顺序与根据治疗时年龄、肿瘤大小、细胞类型和ISDNA升序排列病例所预测的死亡顺序进行比较。使用秩相关系数检验，发现只有ISDNA的秩顺序与观察到的死亡顺序之间的相关性具有统计学意义。我们认为，改良的卡伦德细胞类型分类系统在预测眼球摘除术后生存时间方面的局限性与用于肿瘤分类的类别相对较少（四个）有关，而ISDNA代表了一个无限类别的连续谱。因此，ISDNA在选择具有高恶性潜能的肿瘤时更具鉴别力。
