Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

Arquivos Brasileiros de Oftalmologia

James Jay Augsburger²  Zélia Maria Corrêa²  Nikolaos Trichopoulos¹ 

[1] ,University of Cincinnati Department of Ophthalmology Cincinnati Ohio ,USA

关键词: Choroid neoplasms;    Melanoma;    Cytodiagnosis;    Melanoma;    Biopsy needle;    Biopsy;    fine-needle;    Uveal neoplasms;    Neoplasias da coróide;    Melanoma;    Citodiagnóstico;    Melanoma;    Biopsia por agulha fina;    Neoplasias uveais;   

DOI  :  10.1590/S0004-27492013000200004

来源: SciELO

【 摘 要 】

PURPOSE: Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB) is a significant prognostic factor for death from metastasis. METHODS: Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cross-tabulation. Prognostic significance of cytopathologic classification was evaluated by Kaplan-Meier and Cox proportional hazards analysis. RESULTS: Of 302 studied biopsies, 260 (86.1%) yielded sufficient cells for cytopathologic classification. Eighty of the 260 patients who had a sufficient specimen have already died (P=0.021), 69 from metastatic uveal melanoma. Cell type assigned by cytopathology was strongly associated with metastasis/metastatic death in this series (P=0.0048). Multivariate analysis showed cytopathologic classification to be an independently significant prognostic factor for metastatic death (P=0.0006). None of the 42 patients whose tumor yielded insufficient aspirates (sampled in at least two sites) have developed metastasis or died of metastasis thus far. CONCLUSION: In this series, cytopathology of fine-needle aspiration biopsy samples obtained from uveal melanomas was strongly prognostic of death from metastasis. Insufficiently aspirates (2 or more sites sampled) proved to be prognostic of a favorable outcome (i.e., not developing metastasis).

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