睫状体脉络膜黑色素瘤的十大最大核仁平均值、微循环结构与预后

Mean of the ten largest nucleoli, microcirculation architecture, and prognosis of ciliochoroidal melanomas.

作者信息

Pe'er J, Rummelt V, Mawn L, Hwang T, Woolson R F, Folberg R

机构信息

Department of Ophthalmology, University of Iowa, Iowa City 52242.

出版信息

Ophthalmology. 1994 Jul;101(7):1227-35. doi: 10.1016/s0161-6420(94)31184-5.

DOI:10.1016/s0161-6420(94)31184-5

PMID:8035986

Abstract

BACKGROUND

Cytomorphometric measurements and the architecture of the microcirculation in tissue sections of eyes removed for ciliary body or choroidal melanomas have been identified independently as prognostically significant factors for survival. The relative significance of these two histologic features is addressed in this study.

METHODS

The same 234 cases used to assess the prognostic significance of the microcirculatory patterns of choroidal and ciliary body melanomas were examined by two independent observers who measured the largest diameter of melanoma cell nucleoli from digitized images at a high magnification (x 3000) using the laser scanning confocal microscope. The mean of the ten largest nucleoli was calculated for each tumor according to previously published methods. Intraobserver and interobserver reproducibility was assessed for these measurements. Several Cox multiple regression models were constructed which included this cytomorphometric variable with and without the inclusion of the microcirculatory patterns.

RESULTS

There is a high degree of intraobserver reproducibility but only a weak degree of interobserver reproducibility in measuring the mean of the ten largest nucleoli. Using multiple Cox regression models, the mean of the ten largest nucleoli from each observer failed to exert any effect on outcome after enucleation, regardless of whether the presence of networks of closed vascular loops was considered in the statistical formulation. The presence of networks of closed vascular loops was found to be the most statistically dominant histologic prognostic characteristic.

CONCLUSION

The authors have not been able to confirm the use of the mean of the ten largest nucleoli as a significant prognostic factor in the outcome of patients whose eyes have been removed for ciliary body or choroidal melanomas. Further investigation of this cytomorphometric technique by other laboratories is warranted.

摘要

背景

对于因睫状体或脉络膜黑色素瘤而摘除眼球的组织切片，细胞形态计量学测量以及微循环结构已被独立确定为具有预后意义的生存因素。本研究探讨了这两种组织学特征的相对重要性。

方法

由两名独立观察者对用于评估脉络膜和睫状体黑色素瘤微循环模式预后意义的234例相同病例进行检查，他们使用激光扫描共聚焦显微镜在高倍放大（×3000）下从数字化图像测量黑色素瘤细胞核仁的最大直径。根据先前发表的方法计算每个肿瘤十个最大核仁的平均值。评估这些测量的观察者内和观察者间的可重复性。构建了几个Cox多元回归模型，其中包括这个细胞形态计量学变量，同时考虑了有无微循环模式。