手指甲下恶性黑色素瘤八例报告  

Malignant melanoma beneath nail:a report of 8 cases

作　　者：王臻[1] 梁戈[1] 傅炳峨[1] 范清宇[1] 

机构地区：[1]第四军医大学西京医院骨科,第四军医大学唐都医院骨科

出　　处：《中华手外科杂志》1995年第3期141-143,共3页Chinese Journal of Hand Surgery

摘　　要：为提高临床对手指甲下恶性黑色素瘤的认识，对我科１９８２～１９９２年收治的８例手指甲床恶性黑色素瘤进行分析。肿瘤发生部位；拇指甲床６例，食指甲床１例，食指末端皮肤１例。大部分病人未能早期诊治，症状出现至确诊时间平均７年２个月。主要采用诚指术及转移淋巴结清扫术，并辅以免疫治疗、化疗及放疗。８例中无病存活３例，带病存活２例，死亡３例。中位存活时间４年８个月，平均无病存活时间２年８个月。本组结果提示早期确诊非常重要，凡可疑病变均应做病理检查，一旦确诊即行手指截除术。术后免疫治疗有一定效果，免疫治疗应持续１～２年，以后间断巩固治疗。转移病灶对放疗、化疗不敏感。术后应严密随访．积极治疗转移病灶。To better understand the Subnail malignant melanoma, we analyzed the cases treated from 1982 to1992. Eight patients buffered subnail melanoma, of which 6 were at the thumb nailbed,1 at the indexnailbed and 1 at the tip of the index finger. The delay of diagnosis after the onset of symptoms averaged7 years and 2 months. The main treatment were amputation and lymphadenectomy. combined with immuotherapy, chemutherapy and racliotherapy. Three of the eight patients survived without disease, 2 survived with disease and 3 died. The medium survival time was 4 years 8 months. The average survivaltime without disease was 2 years and 8 months. We suggest that early diagnosis is important and amputation should be performed immediately after the establishment of diagnosis. lmmunotherapy has someeffect, which should be given for 1～2 years continuously and then at intervals. The metastases are notsensitive to radiotherapy or chemotherapy. The patients should be followed up closely to get activetreatment of metastases.

关 键 词：黑色素瘤 手指肿瘤 手指甲下瘤 病例报告 

分 类 号：R739.96[医药卫生—肿瘤]