PURPOSE To investigate the relationship between surgical approach for intraocular tumor biopsy of uveal melanoma and tumor morphologic features such as size and intraocular location and the effect of these variables on diagnostic yield and biopsy outcome. METHODS Consecutive patients from nine Ocular Oncology centers with uveal melanoma (UM) undergoing tumor biopsy immediately preceding I125 plaque brachytherapy with tissue sent for gene expression profiling (GEP) testing were reviewed retrospectively. RESULTS Three hundred sixty patients were included (50% men, mean age 60.2 years). Overall biopsy yield was 99% and 83% for GEP and cytopathology, respectively. Surgeon choice of biopsy approach (trans-vitreal vs. trans-scleral) was found to associate with both tumor location and tumor thickness. A trans-scleral rather than trans-vitreal approach was used more commonly for anteriorly located tumors (92% vs. 38% of posterior tumors, p < 0.001) and thicker tumors (86% vs. 55% of thin tumors, p < 0.001). When performing trans-vitreal biopsies, ocular oncologists with previous vitreoretinal surgery fellowship training were more likely to use wide-field surgical viewing systems, compared with indirect ophthalmoscopy (82.6% vs. 20.6%, p < 0.001). Surgical complications were rare and occurred more frequently with trans-vitreal biopsies (3.6% vs. 0.46%, p = 0.046). CONCLUSIONS In this multi-center analysis of UM tumor biopsy, surgical yield was high for obtaining tumor tissue for GEP and cytopathology analysis with both trans-scleral and trans-vitreal techniques. Fellowship-trained ocular oncologists' preferred intraocular biopsy techniques associated strongly with tumor location, tumor thickness, and fellowship training of the surgeon. Short-term complication rates were low.

中文翻译：

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葡萄膜黑色素瘤眼内活检技术和结果的多中心分析：眼肿瘤学研究联盟报告 4。

目的 探讨葡萄膜黑色素瘤眼内肿瘤活检的手术方法与肿瘤形态特征（如大小和眼内位置）之间的关系，以及这些变量对诊断率和活检结果的影响。方法 对来自 9 个眼肿瘤中心的连续葡萄膜黑色素瘤 (UM) 患者进行回顾性分析，这些患者在 I125 斑块近距离放射治疗之前接受肿瘤活检，并将组织送去进行基因表达谱 (GEP) 测试。结果 纳入 360 名患者（50% 为男性，平均年龄 60.2 岁）。GEP 和细胞病理学的总活检率分别为 99% 和 83%。研究发现，外科医生选择的活检方法（经玻璃体还是经巩膜）与肿瘤位置和肿瘤厚度有关。经巩膜而非经玻璃体入路更常用于前部肿瘤（后部肿瘤为 92% vs. 38%，p < 0.001）和较厚肿瘤（薄肿瘤为 86% vs. 55%，p < 0.001） ）。在进行经玻璃体活检时，与间接检眼镜检查相比，接受过玻璃体视网膜手术专科培训的眼肿瘤科医生更有可能使用宽视野手术观察系统（82.6% vs. 20.6%，p < 0.001）。手术并发症很少见，并且经玻璃体活检发生的频率更高（3.6% vs. 0.46%，p = 0.046）。结论 在这项对 UM 肿瘤活检的多中心分析中，使用经巩膜和经玻璃体技术获取肿瘤组织进行 GEP 和细胞病理学分析的手术收率很高。经过专科培训的眼肿瘤科医生首选的眼内活检技术与肿瘤位置、肿瘤厚度和外科医生的专科培训密切相关。短期并发症发生率较低。