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題名 | 葡萄膜惡性黑色素細胞癌--臨床研究=Clinical Study of Malignant Uveal Melanoma |
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作者 | 方怡謨; 周介仁; 廖述朗; 侯平康; | 書刊名 | 慈濟醫學 |
卷期 | 13:1 2001.03[民90.03] |
頁次 | 頁41-46 |
分類號 | 416.74 |
關鍵詞 | 葡萄膜惡性黑色素細胞癌; 脈絡膜; 睫狀體; Malignant uveal melanoma; Epithelioid cell type; Metastasis; |
語文 | 中文(Chinese) |
中文摘要 | 目的:本文主要觀察葡萄膜惡性黑色素細胞癌,其臨床表現在亞洲黃 種人與西方白人是否有所不同?病人與方法:我們收集由民國七十七年至民國八 十八年在台大醫院被診斷為葡萄膜惡性黑色素細胞癌病例。以回溯性研究方式, 探討其好發年齡、臨床症狀、腫瘤病理細胞形態、治療方法、有無腫瘤轉移及其 可能的危險因子。結果:我們收集了18例,其中10例為男性、8例為女性。追 蹤的時間由4個月到7年,平均3.8年。發病的年齡以50歲到60歲為最多。原 發腫瘤的位置以脈絡膜(choroid) 為最多。症狀以視力喪失,視力模糊最常見。病 理細胞形態以混合細胞型(mixed cell type)為最多。在追蹤期間總共有5例發生轉 移,最常轉移至肝臟。發生轉移者之病理細胞形態以類上皮細胞型(epithelioid cell type)最多,5例轉移的病例中有4例在診斷後3個月內發生轉移。統計上發現睫 狀體(ciliary body)的原發腫瘤易發生轉移,而腫瘤最大直徑與轉移的發生無關。 結論:葡萄膜惡性黑色素細胞癌好發於成人,以50至60歲為最多。在亞洲黃種 人仍以類上皮細胞型產生轉移為最多,預後也最差。治療方法仍以眼球摘除術為 主。至於在腫瘤轉移的危險因子方面,我們的觀察發現(1)類上皮細胞,(2)前葡 萄膜位置,如睫狀體轉移的機會較大,但與外國文獻不同的是轉移與腫瘤最大直 徑無關。以肝臟功能生化檢查來預測腫瘤發生轉移的陽性預測值是相當不理想。 利用核子醫學檢查:正子發散斷層掃瞄(positron emission tomography)及單一光子發 散電腦斷層掃瞄(single photon emission computed tomography)來增加偵測腫瘤轉移 的準確度,不失為未來的一個發展方向。(慈濟醫學 2001; 13: 41-46) |
英文摘要 | Objective: The purpose of this study is to compare the clinical features of malignant uveal melanoma in Caucasians with those in Asians. Patients and Methods: We retrospectively reviewed the records of patients who were diagnosed with primary malignant uveal melanoma from 1988 to 1999 in the department of Ophthalmology, National Taiwan University Hospital. Data were analyzed for age at onset, symptoms, pathological cell types, treatment, and possible risk factors for metastasis. Results: We collected 18 patients. Fifteen patients (83%) had disease involving the cho-roids. Blurring of vision was the chief complaint for 13 (72%) patients with visual acuity less than 0.1. Mixed cell type melanoma was the most common pattern, yet the epithelioid type had the highest rate (75%) of metastasis. The liver was the most common site of metastasis. Enucleation was still the treatment of choice. Conclusions: We found that the epithelioid type of melanoma and an anterior location of the tumor were risk factors for metastasis in primary malignant uveal melanoma. However, the size of the tumor was not a risk factor in our study, which was different from previous reports in Caucasians. (Tzu Chi Med J 2001; 13:41-46) |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。