Purpose: The aim of the study was to evaluate equivalence of growth rate and pathologic confirmation in small choroidal melanoma (SCM). Design: This study is a case series. Subjects, Participants, and Controls: A total of 61 patients with a choroidal melanocytic tumor of size 5.0–16.0 mm in the largest basal diameter and 1.0–2.5 mm in thickness were classified into the pathology-confirmed group (n = 19), growth-confirmed group (n = 30), and with combined observations (n = 12). Methods: Distribution of clinical variables (age, gender, laterality, tumor dimensions, tumor location, and presence of orange pigment, subretinal fluid, drusen, and retinal pigment epithelial [RPE] atrophy) between the groups was analyzed. Patient and disease characteristics were summarized as the median and interquartile range for continuous variables and the frequency and percentage for categorical variables. Comparisons were made using the Wilcoxon rank sum test for continuous variables and either Fisher’s exact test or the χ² test for categorical variables with a p value threshold of 0.05 for statistical significance. Growth rate (change in basal dimension/12 months) diagnostic of SCM was quantified. Main Outcome Measures: The primary aim of this study was to test the hypothesis that “growth” was diagnostic of SCM with the secondary aim of quantifying the malignant “growth rate” (growth rate of SCM). Results: The clinical characteristics among all 3 groups were similar except more patients with symptoms (68 vs. 20 vs. 42%, p = 0.004) and juxtapapillary location (p = 0.03) were in the pathology group than in the growth-confirmed group. Those in the combined and growth-confirmed groups had more patients with drusen (11 vs. 60 vs. 50%, p = 0.003) and RPE atrophy (11 vs. 23 vs. 67%, p = 0.003), respectively, than in the pathology group. The median time to detect growth was 9 months (range 3–26 months). The mean growth rate in basal dimension was 1.8 mm/12 months (range, 0.0–7.4 mm; [95% CI: 1.32–2.28]). Conclusions and Relevance: Choroidal melanocytic lesions exhibiting a defined growth rate can be clinically diagnosed as SCM without a need for biopsy.
Ocul Oncol Pathol

中文翻译：

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小脉络膜黑色素瘤：生长速度与病理学的相关性


目的：本研究的目的是评估小脉络膜黑色素瘤（SCM）的生长速度和病理证实的等效性。设计：本研究是一个案例系列。受试者、参与者和对照：总共 61 例最大基底直径为 5.0-16.0 mm、厚度为 1.0-2.5 mm 的脉络膜黑色素细胞肿瘤患者被分为病理证实组 ( n = 19)，生长情况-确认组（ n = 30），并结合观察结果（ n = 12）。方法：分析各组之间临床变量的分布（年龄、性别、偏侧性、肿瘤尺寸、肿瘤位置以及橙色素、视网膜下液、玻璃疣和视网膜色素上皮 [RPE] 萎缩的存在）。患者和疾病特征总结为连续变量的中位数和四分位数范围以及分类变量的频率和百分比。使用连续变量的 Wilcoxon 秩和检验和分类变量的 Fisher 精确检验或 χ ²检验进行比较，统计显着性的p值阈值为 0.05。对 SCM 诊断的生长率（基础尺寸变化/12 个月）进行了量化。主要结果指标：本研究的主要目的是检验“生长”是 SCM 诊断的假设，次要目的是量化恶性“生长率”（SCM 的生长率）。结果：所有 3 组的临床特征相似，只是出现症状的患者较多（68% vs. 20% vs. 42%， p = 0。004）和近乳头位置（ p = 0.03）在病理组中比在生长确认组中要高。合并组和生长确认组的玻璃膜疣患者（11% vs. 60% vs. 50%， p = 0.003）和 RPE 萎缩患者（11% vs. 23 vs. 67%， p = 0.003）分别比对照组更多。病理组。检测生长的中位时间为 9 个月（范围 3-26 个月）。基础尺寸的平均生长率为 1.8 毫米/12 个月（范围，0.0–7.4 毫米；[95% CI：1.32–2.28]）。结论和相关性：表现出确定生长速度的脉络膜黑素细胞病变可在临床上诊断为 SCM，无需活检。
 眼肿瘤病理