直肠肛管恶性黑色素瘤诊治体会  

Diagnosis and treatment of anorectal malignant melanoma

作　　者：朱玉萍[1] 冯海洋[1] 刘勇[1] 钱俊[1] 陈寅波[1] 李德川[1] 

机构地区：[1]浙江省肿瘤医院大肠外科,浙江杭州310022

出　　处：《实用肿瘤杂志》2009年第4期369-371,共3页Journal of Practical Oncology

摘　　要：目的探讨直肠肛管恶性黑色素瘤的临床特点及生存分析。方法回顾性分析22例直肠肛管恶性黑色素瘤患者的临床资料和生存率。结果本组22例,占同期收治结直肠癌的0.3%(22/7300),首发症状为便血(77.3%),误诊率68.2%,首诊转移率63.6%;腹会阴联合切除术16例,局部切除术4例;辅助化疗9例,辅助免疫治疗6例;辅助放疗1例。22例患者1、3、5年生存率分别为54.5%、13.6%、9.1%。中位生存时间12月(95%CI:7.48-16.52)。结论直肠肛管恶性黑色素瘤少见,易误诊,易转移,预后差。外科治疗是目前无转移直肠肛管恶性黑色素瘤的首选治疗方法。Objective To review the diagnosis and treatment of anorectal malignant melanoma （ARMM）. Methods Clinicopathological data,including clinical features,diagnosis,surgical modelities and prognosis of 22 patients with ARMM were analyzed retrospectively. Results Twenty-two ARMM cases were enrolled,which accounted for 0.3% of all admitted patients with colorectal cancer at the same period. The most common complaints were hematochezia （77. 3%）, and the misdiagnosis rate was 68.2%. The metastasis rate before diagnosis was 63.6%. Of 22 patients 16 underwent abdominoperineal resection, 4 underwent extensive local excision, 9 received adjuvant chemotherapy, 6 received adjuvant immunotherapy and 1 received radiotherapy. The 1-,3-,and 5-year survival rates of the 22 patients were 54.5% ,13.6% and 9.1% ,respectively. The median survival time was 12 months （95% CI： 7. 48-16. 52 months）. Conclusions ARMM is a rare disease with poor prognosis,and surgery may be considered as the first choice for patients without distant metastasis.

关 键 词：黑色素瘤/外科学 黑色素瘤/诊断 黑色素瘤/治疗 直肠肿瘤/外科学 直肠肿瘤/诊断 

分 类 号：R735.3[医药卫生—肿瘤]