Rummelt V, Folberg R, Woolson R F, Hwang T, Pe'er J
Department of Ophthalmology, University of Iowa, Iowa City 52242-1182, USA.
Ophthalmology. 1995 May;102(5):844-51. doi: 10.1016/s0161-6420(95)30947-5.
To study the relation between vascular patterns and the biologically aggressive behavior of ciliary body melanomas.
The authors compared the frequency distribution of vascular patterns by location for 234 uveal melanomas (54 tumors involving the ciliary body, and 180 without ciliary body involvement). Stepwise Cox regressions (for the endpoint of time-to-death due to melanoma), performed separately for melanomas with and without ciliary body involvement, included the following variables: size, vascular patterns, cell type, mean of the largest nucleoli, mitoses, tumor infiltrating lymphocytes, age, and sex. A separate Cox regression procedure included the variable of tumor location. Kaplan-Meier survival curves were generated for time to melanoma death with ciliary body involvement and melanomas without ciliary body involvement for tumors containing or lacking vascular networks.
These vascular patterns appear more often in the ciliary body than in the choroid: parallel vessels (P = 0.022), arcs (P = 0.003), and parallel with cross-linking, arcs with branching, and loops and networks (all P = 0.0001). Stepwise regression for tumors confined to the choroid indicated that the presence of networks was the most significant variable (P = 0.0001); stepwise regression for tumors with ciliary body involvement suggested that only one variable, networks, was significant (P = 0.0066). Kaplan-Meier survival estimates indicated that the survival of patients with tumors containing networks in the ciliary body was comparable to those containing networks in the choroid.
Regardless of location, ciliary body or choroid, the presence of vascular networks shortens survival. The tumor location does not enter a stepwise Cox regression model when vascular patterns are included as variables. Therefore, the aggressive behavior of ciliary body melanomas appears to be related to the tendency for vascular networks to develop in this location.
研究睫状体黑色素瘤的血管形态与生物学侵袭性行为之间的关系。
作者比较了234例葡萄膜黑色素瘤（54例累及睫状体的肿瘤和180例未累及睫状体的肿瘤）按部位划分的血管形态频率分布。分别对累及睫状体和未累及睫状体的黑色素瘤进行逐步Cox回归分析（以黑色素瘤导致的死亡时间为终点），纳入以下变量：大小、血管形态、细胞类型、最大核仁均值、有丝分裂、肿瘤浸润淋巴细胞、年龄和性别。另一个单独的Cox回归分析纳入了肿瘤部位变量。针对有或无血管网络的肿瘤，生成了累及睫状体黑色素瘤和未累及睫状体黑色素瘤至黑色素瘤死亡时间的Kaplan-Meier生存曲线。
这些血管形态在睫状体中比在脉络膜中更常见：平行血管（P = 0.022）、弧形血管（P = 0.003）以及平行伴交联、弧形伴分支、环和网络状血管（均P = 0.0001）。局限于脉络膜的肿瘤的逐步回归分析表明，网络状血管的存在是最显著的变量（P = 0.0001）；累及睫状体的肿瘤的逐步回归分析表明，只有网络状血管这一个变量具有显著性（P = 0.0066）。Kaplan-Meier生存估计表明，睫状体中含有网络状血管的肿瘤患者的生存率与脉络膜中含有网络状血管的肿瘤患者相当。
无论位于睫状体还是脉络膜，血管网络的存在都会缩短生存期。当将血管形态作为变量纳入时，肿瘤部位未进入逐步Cox回归模型。因此，睫状体黑色素瘤的侵袭性行为似乎与该部位形成血管网络的倾向有关。
