["黑色素瘤92：法国葡萄膜黑色素瘤的流行病学研究"]

["Melanoma 92". epidemiological study of uveal melanoma in France].

作者信息

Vidal J L, Bacin F, Albuisson E, Rozan R, Desjardins L, D'Hermies F, Grange J D, Chauvel P, Caujolle J P, Sahel J

机构信息

Service d'Ophtalmologie, Hôpital Gabriel-Montpied, Clermont-Ferrand.

出版信息

J Fr Ophtalmol. 1995;18(8-9):520-8.

PMID:7560797

Abstract

PURPOSE

The purposes of this study were to evaluate the incidence of uveal melanoma in France in 1992, to describe the characteristics of the tumors and their treatments.

METHODS

This was a retrospective and multicentric study. First a questionnaire was sent to 4575 French ophthalmologists asking whether they had established a diagnosis of uveal melanoma during 1992, and if so, to describe the tumor and its management. Then the patients files were reviewed in the specialized treatment centers (Paris, Lyon, Nice, Strasbourg, Bordeaux, Clermont-Ferrand). All the data were statistically analysed.

RESULTS

412 new cases of uveal melanomas were registered (incidence 0.7/100000) affecting 234 females and 178 males. The cases ranged in age from 7 to 93 years (mean 61.5 years). There were 5 (1%) isolated tumors of the iris, 75 (18%) of the ciliary body, either isolated (10%) either associated to iris and/or to choroïdal tumors and 332 (81%) choroïdal melanomas. 201 (53%) tumors were posterior to the equator and 153 (40%) had a margin at less than 3 mm of the optic disc; 87 (21%) melanomas were detected in asymptomatic patients. In 29 (7%) other cases, the diagnosis was established after enlargement of the tumor. In all other eyes, symptoms were present. 17% of the melanomas were T1, 34% were T2, et 48% were T3. 353 (86%) melanomas were pigmented, 30 (7%) were achromic and 29 (7%) of the mixed color type. 156 (38%) tumors were associated with a retinal detachment. In 12 cases (3%), at presentation there was an extrascleral extension. 9 patients (2%) had metastases (7 to the liver, 1 to the lungs and 1 to the lungs and bones). The study of the patients residence and work did not show any environmental risk factor. The initial treatment was protontherapy in 251 patients (63%), plaque therapy in 91 (23%), enucleation in 40 (10%), and other methods in 18.

CONCLUSION

This was the first epidemiologic study conducted in France on this subject. It describes the clinical features of the disease, its geographical display and its management in this country.

摘要

目的

本研究旨在评估1992年法国葡萄膜黑色素瘤的发病率，描述肿瘤特征及其治疗方法。

方法

这是一项回顾性多中心研究。首先向4575名法国眼科医生发送问卷，询问他们在1992年是否确诊过葡萄膜黑色素瘤，若确诊，描述肿瘤及其治疗情况。然后在专业治疗中心（巴黎、里昂、尼斯、斯特拉斯堡、波尔多、克莱蒙费朗）查阅患者病历。对所有数据进行统计分析。

结果

共登记412例新的葡萄膜黑色素瘤病例（发病率0.7/100000），其中女性234例，男性178例。病例年龄范围为7至93岁（平均61.5岁）。有5例（1%）虹膜孤立性肿瘤，75例（18%）睫状体肿瘤，其中孤立性肿瘤10%，合并虹膜和/或脉络膜肿瘤75例，脉络膜黑色素瘤332例（81%）。201例（53%）肿瘤位于赤道后方，153例（40%）距视盘边缘小于3mm；87例（21%）黑色素瘤在无症状患者中被检测到。在29例（7%）其他病例中，肿瘤增大后确诊。在所有其他眼中，均有症状。17%的黑色素瘤为T1期，34%为T2期，48%为T3期。353例（86%）黑色素瘤有色素沉着，30例（7%）无色素，29例（7%）为混合色型。156例（38%）肿瘤合并视网膜脱离。12例（3%）初诊时有巩膜外扩展。9例（2%）有转移（7例转移至肝脏，1例转移至肺，1例转移至肺和骨骼）。对患者居住和工作情况的研究未显示任何环境危险因素。初始治疗中，251例患者（63%）接受质子治疗，91例（23%）接受敷贴治疗，40例（10%）接受眼球摘除术，18例采用其他方法。