230例手术治疗的口腔黏膜恶性黑色素瘤患者预后的多因素分析  

Multivariate analysis of the prognostic factors in 230 surgically treated oral mucosal malignant melanomas

作　　者：刘云生[1] 杨春惠[2] 孙亚夫[3] 耿波 袁奎封[5] 邱蔚六[6] 

机构地区：[1]山东大学齐鲁医院口腔颌面外科,山东济南250012 [2]山东中医药大学附属二院口腔颌面外科,山东济南250001 [3]济南千佛山医院口腔颌面外科,山东济南250012 [4]山东省人民医院口腔颌面外科,山东济南250001 [5]山东大学第二医院口腔颌面外科,山东济南250013 [6]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科

出　　处：《上海口腔医学》2005年第5期466-471,共6页Shanghai Journal of Stomatology

摘　　要：目的:探讨影响口腔黏膜恶性黑色素瘤患者生存率的因素。方法:单纯手术治疗的口腔黏膜恶性黑色素瘤患者230例,男141例,女89例。TNM分期:Ⅰ期,34例;Ⅱ期,87例;Ⅲ期,109例。采用Cox比例风险模型进行预后因素筛选,Kaplan-Meier法进行影响因素及生存率的分析。Logrank法比较不同生存分布的差异。结果:肿瘤厚度、淋巴结转移、肿瘤有无溃破及原发部位是影响生存率的相对独立因素,其P值与RR值依次分别为:P<0.001、1.868,P<0.001、1.685,P<0.001、1.411,P=0.008、0.747。各因素不同水平间统计学差异明显。资料未显示年龄(P=0.136)、性别(P=0.721)及所用手术方法(P=0.944)对生存率有显著影响。结论:影响口腔黏膜恶性黑色素瘤的预后因素与皮肤部位发病者类似。各因素间无明显相互作用。单纯手术治疗并非最佳治疗措施。PURPOSE： To analyze the prognostic factors which influence the survival rates in oral mucosal malignant melanoma patients. METHODS： 230 consecutive patients with oral mucosal malignant melanoma were included in the study.There were 141 males and 89 females.34 were in （TNM） Ⅰ stage, 87 in Ⅱ stage and 109 in Ⅲ stage. Cox proportional hazards model was used to analyze the statistically significant prognostic factors. Kaplan-Meier method was used to analyze the survival rate under the different levels of the different factors and Log rank method for comparison of the distribution of the different survival rates. RESULTS： The prognostic factors include the thickness of the tumor, cervical lymph node metastasis, the presence or absence of ulceration and the anatomic sites. The P value and the relative risk were P〈0.001,RR=1.868; P〈0.001,RR=1.685; P〈0.001,RR=1.411; P=0.008, RR=0.747, respectively. The different factors were independent with each other. The factors of sex （P=0.136）, age （P=0.721）and the surgical method used （P=0.944） had no influence on survival rates in this study. CONCLUSIONS： The significant prognostic factors which influence the survival rates in oral mucosal malignant melanoma patients were similar to that in the skin malignant melanoma patients. The factors did not have factor-by-factor interactions. Surgery alone is not the best treatment of choice for oral mucosal melanoma.

关 键 词：恶性黑色素瘤 COX比例风险模型 预后因素 口腔黏膜 

分 类 号：R739.8[医药卫生—肿瘤]