Introduction: Trans-scleral biopsy of uveal melanoma (UM) poses an inherent risk of tumor and possibly retinal perforation. We describe a novel technique for trans-scleral biopsy of UM and evaluate its safety and efficacy in an initial cohort of patients. Methods: A retrospective, consecutive observational case series was conducted from October 14, 2019, to April 15, 2020, at Kaiser Permanente, San Francisco, CA among patients with UM of the ciliary body or anterior choroid undergoing trans-scleral fine-needle aspiration biopsy using a novel guarded needle technique. Results: A total of 6 patients were included in the study, with a mean age of 64.3 (range 35–77) years (5 women 83%). Mean (±SD) tumor thickness and maximal basal diameter were 6.4 (±2.66) and 11.9 (±2.13) mm, respectively. Five out of 6 patients achieved a successful biopsy with reliable gene expression profiling (GEP) results. The only failure to obtain specimen occurred in the first attempted patient and, after a minor technique modification, all subsequent biopsies were successful. No intraoperative or short-term postoperative complications were observed in any patient. Conclusion: This novel trans-scleral biopsy technique appears to be safe and effective when obtaining UM tissue for GEP. This method may provide a more controlled biopsy depth thereby minimizing the risk of tumor perforation and its associated complications while still obtaining adequate biopsy yield.
Ocul Oncol Pathol

中文翻译：

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葡萄膜黑色素瘤的新型保护针经巩膜活检：一项初步研究

简介：葡萄膜黑色素瘤 (UM) 的经巩膜活检具有肿瘤和可能的视网膜穿孔的固有风险。我们描述了一种用于 UM 经巩膜活检的新技术，并在初始患者队列中评估其安全性和有效性。方法：从 2019 年 10 月 14 日到 2020 年 4 月 15 日，在加利福尼亚州旧金山的 Kaiser Permanente 对接受经巩膜细针穿刺的睫状体或前脉络膜 UM 患者进行回顾性、连续观察性病例系列研究。使用一种新颖的保护针技术进行活检。结果：该研究共纳入 6 名患者，平均年龄为 64.3（范围 35-77）岁（5 名女性，83%）。平均 (±SD) 肿瘤厚度和最大基底直径分别为 6.4 (±2.66) 和 11.9 (±2.13) mm。6 名患者中有 5 名通过可靠的基因表达谱 (GEP) 结果成功进行了活检。唯一未能获得标本的情况发生在第一个尝试的患者中，经过轻微的技术修改后，所有后续活检均成功。在任何患者中均未观察到术中或短期术后并发症。结论：这种新颖的经巩膜活检技术在获得用于 GEP 的 UM 组织时似乎是安全有效的。这种方法可以提供更可控的活检深度，从而最大限度地降低肿瘤穿孔及其相关并发症的风险，同时仍能获得足够的活检产量。
眼肿瘤病理