| Objective 1) To investigate the safety and effect of local resection of uveal melanoma, analyze the factors interrelated with vision, outlook of eyeball, complications, and metastasis and relapse of the tumor after the surgical operation; 2) To determine clinical value of serum melanoma-inhibiting activity (MIA) and vascular endothelial growth factor (VEGF) in patients with uveal melanomas.Methods 1) Among patients of uveal melanoma with local resection treatment and confirmed by histopathology from June, 1996 to June, 2003, 45 cases, whose tumor was fully resected with a formal follow-up and whose record was well documented, were selected in this study. The examination concerned with both of clinical factors and therapy treatments. The former one included age, sex, vision and eye pressure before and after operation, the largest diameter and height of tumor, the pathology-type and localization of tumor, and the extent ofretina detachment. The latter contained operation protocols applied, joint-therapy methods, infiltration of sclera, and tumor resection. The micro-vascular density in tumor tissues and the expression of vascular endothelial growth factor (VEGF) were assayed by immuno-histochemical staining of the blood factor Vffi-related antigen (FVffi-RAg). The software package SPSS 10.0 was applied for statistical analyses, including t test, x2 test, one-way Anova method of square-deviation (SD), and logistic regression. The factors concerned with vision prognosis, outward prognosis, complication, and metastasis and relapse were obtained respectively. Furthermore, the factors, closely related with tumor metastasis and relapse, were found out by use of the Kaplan-Meier method. A COX regression model was established to analyze the peaks of the metastasis and relapse, and the life curves of patients. 2) The serum samples from 27 patients with uveal melanoma (12 cases of male, 15 of female, average 42.16 years old) were examined. Among them, sclera infiltration and remote metastasis occurred in 8 cases, and non-metastasis in 19 cases. Spindle cell was found in 17 cases, epithelioid cell in 3 cases, and mixed cell in7 cases. In addition, 6 samples were from patients with uveal melanocytoma, and 7 samples from those with other eye tumors (4 cases of adenoma of non-pigmented ciliary epithelium, 2 of retinoblastoma, and 1 of retinal angioma). 16 normal sera were also obtained. All samples were kept at -20 癈 until use. The serum levels of MIA and VEGF were detected by means of ELISA.Results 1) The time of follow-up was more than 6 months, average 32.6 ?20.5 months, in those 45 patients of uveal melanoma with local resection treatment. The relapse was occurred in 3 cases (6.7 %), the metastasis in 2 cases (4.4 %), and death in 1 case (2.2 %).a) vision prognosis: the factors concerned with the vision prognosis were the vision before operation and the successive retinal detachment. Theh1 coefficients of logistic regression were 7.843 and -3.454, and the constant was 2.889. The visual acuities of those eyes with a weaker vision before operation (0.16 ?0.15) were usually increased after the operation (0.51 ?0,25). However, the visual acuities of the eyes with a better vision before operation (0.66 ?0.44) were often decreased after the operation (0.18 ?0.17). For the eyes with a13successive retinal detachment before operation (0.55 ?0.46), the vision prognosis was not so good after the operation (0.17 ?0.16).b) complications: the most important factors concerned with complication occurrence were the eye pressure before operation and the integrity of tumor resection. The coefficients of logistic regression were 0.122 and 3.521 respectively, and the constant was 18.763. The higher the eye pressure, the higher the possibility of eyeball atrophy; the more the integrity of tumor resection, the more the complication occurrence in the operations.c) prognosis of eyeball outlook: the most important factors concerned with the prognosis of eyeball outlook were th...
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