本文已被:浏览 457次 下载 433次
Received:April 29, 2022 Published Online:March 20, 2023
Received:April 29, 2022 Published Online:March 20, 2023
中文摘要: 目的 分析老年患者葡萄膜黑色素瘤(UM)的临床病理特点。方法 采用回顾性研究方法,收集2018年1月—2022年2月上海交通大学医学院附属第九人民医院收治的UM 57例,以年龄60岁为界,分为老年组与非老年组,对比分析其临床病理特征及分子遗传学改变。结果 老年组23例,男性15例,女性8例;发生于左眼14例,右眼9例。非老年组34例,男性22例,女性12例,发生于左眼18例,右眼16例。两组UM均发生于脉络膜。老年组UM最大径 [(12.96±1.23) mm vs (10.18±0.74) mm,P<0.01]和厚度均大于非老年组[(4.35±0.43) mm vs (3.68±0.36) mm,P<0.01]。免疫组化标记Ki-67≥5%发生率也较非老年组增高(65.22% vs 35.29%,P<0.05),同时在组织学亚型、浸润淋巴细胞、坏死、核分裂相、AJCC分期等方面也存在一定差异,但未显示统计学意义。分子遗传学检查发现,两组均存在3号、8号染色体异常;老年组8号染色体异常阳性率较非老年组略高,但差异无统计学意义(2/6 vs 0/8, P=0.165)。结论 老年患者UM与非老年患者间存在一定差异,需充分了解其临床病理特征以利于诊断及治疗。
Abstract:Objective To study the clinicopathological characteristics of uveal melanoma (UM) in elderly patients. Methods A retrospective study was performed on 57 patients with UM, who were admitted to the Shanghai Ninth People's Hospital from January 2018 to February 2022. They were divided into the elderly group (over the age of 60 years old) and the control group (under the age of 60 years old). The clinicopathological characteristics and molecular genetics alterations were analyzed and compared between two groups. Results There were 15 males and 8 females in elderly group, with 14 cases occurring in the left eye and 9 cases occurring in the right eye. In control group, there were 22 males and 12 females, with 18 cases occurring in the left eye and 16 cases occurring in the right eye. Uveal melanoma occurred in choroid in both groups. The maximum diameter [ (12.96±1.23) mm vs (10.18±0.74) mm, P<0.01] and the thickness [ (4.35±0.43) mm vs (3.68±0.36) mm, P<0.01] of UM in elderly group were significantly greater than those in control group. The expression of immunohistochemical marker Ki-67≥5% was also higher than that in control group (65.22% vs 35.29%, P<0.05). Besides, there were also some differences in histological subtypes, tumor-infiltrating lymphocytes, necrosis extension, mitotic phase progression and AJCC stage, but there was no statistical difference in them between two groups. Molecular genetic examination showed the abnormalities of chromosome 3 and chromosome 8 in both groups, and the positive rate of c-myc for chromosome 8 in elderly group (2/6) was slightly higher than that in control group (0/8), without significant difference in it (P=0.165). Conclusion There are some differences in the clinicopathological features of UM between elderly patients and non-elderly patients. It is necessary to fully understand its clinicopathological characteristics for accurate diagnosis and treatment.
文章编号: 中图分类号: 文献标志码:B
基金项目:上海市卫生健康委员会卫生行业临床研究专项(202040432);上海交通大学医学院附属第九人民医院交叉基金(JYJC201903)
引用文本: