冠状不确定的黑色细胞瘤的恶性转变
Arun D Singh1, Yehonatan Weinberger1,2, Emily C Zabor3,4
1Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
JAMA ophthalmology
|May 22, 2025
概括
使用当前模型预测不确定的黑色素细胞瘤 (IMTs) 中恶性转变的准确性是次优的. 这些模型可能导致过度治疗,突出显示需要改进胸腔神经和IMT风险评估的诊断方法.
科学领域:
- 眼科医生 眼科 眼科
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 准确预测不确定的黑色细胞瘤 (IMTs) 恶性转变的风险,对于适当的患者管理至关重要.
- 目前用于胆道神经和IMT的预测模型的准确性尚不清楚,可能导致过度治疗或治疗不足.
研究的目的:
- 估计患有不确定的黑色细胞瘤 (IMTs) 的患者队列中恶性转变的5年风险.
- 评估协作眼睛黑色素瘤研究 (COMS) 和威尔斯眼科医院 (WEH) 模型在预测恶性转变方面的准确性.
主要方法:
- 一项队列研究包括123名被诊断为IMT的患者,分为良性 (大) 或恶性 (小黑色素瘤).
- 使用COMS和WEH预测模型计算了恶性转变的5年Kaplan-Meier概率.
- 使用Youden指数确定了最佳切割点,以评估模型性能.
主要成果:
- 无论是COMS还是WEH模型,都显示出IMT恶性转变的预测准确度低于最佳.
- 这些模型预测了观察到的黑色素瘤的平均5年黑色素瘤概率为0.39 (COMS) 和0.44 (WEH).
- 对于观察到的 nevi,预测的概率为0.18 (COMS) 和0.31 (WEH),表明了显著的重叠和错误分类的可能性.
结论:
- 目前IMT恶性转变的预测模型是不理想的,可能导致约30%的患者过度治疗.
- 需要进一步研究和验证胆管神经和IMT的替代预测方法.
- 改善风险分层对于准确诊断和眼球黑色细胞病变的管理至关重要.
相关概念视频
01:30Skin Cancer
3.0K
Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
3.0K
02:07Tumor Progression
6.2K
Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
6.2K
02:30Metastasis
5.5K
Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
5.5K