原发于眼睑皮肤恶性黑色素瘤的临床病理分析  

Primary malignant melanoma of eyelid skin：analysis of the clinical and pathological datas

作　　者：王丽丽[1] 李永平[1] 张文忻[1] 刘辉[1] 张平[1] 林健贤[1] 

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室病理室,广州510060

出　　处：《中国实用眼科杂志》2011年第6期583-586,共4页Chinese Journal of Practical Ophthalmology

基　　金：基金项目：本课题为中国国家自然基金资助（30672276）

摘　　要：目的探讨原发于眼睑皮肤黑色素瘤的临床、病理及免疫组化特点。方法回顾中山眼科中心1963年7月到2008年3月收治的12例眼睑皮肤恶性黑色素瘤患者临床资料，观察其临床病理特点并进行免疫组化分析。结果眼睑皮肤黑色素瘤发病多发生于上睑，发病年龄平均在56．42岁，发病无性别、眼别差异。组织病理学以水平扩散型多见（7例，58．3％），其次为结节型（4例，33．3％），恶性雀斑（1例，8．3％）。按细胞形态分型以上皮样细胞型多见，其次为混合细胞型和梭形细胞型。Breslow厚度平均1．73mm。临床分期以I期多见。免疫组化HMB45，S-100染色均呈阳性表达。有随访资料的3例患者中2例于术后1年内死亡。结论眼睑皮肤恶性黑色素瘤是一种预后较差的恶性肿瘤，肿瘤厚度和有丝分裂指数可作为预后相关指标。免疫组化HMB45、S-100染色有助于诊断。Objective To study the clinicopathologic and immunohistochemical features of primary malignant melanomas of eyelid skin. Methods Retrospectively study of 12 cases of malignant melanoma of eyelid skin by pathological diagnosis at Zhongshan Ophthalmic Center between July 1963 and March 2008. The clinical data and histopathologic sections were reviewed and immunohistochemical stains were performed in each case. Results The upper eyelid was more f^equently the site of origin. There was no gender or side prediction. Patients ranged in age from 25 to 85 years with an average of 56.42 years. The histopathologic clas- sification of melanomas included superficial spreading melanoma （58.3%, 7 cases）, nodular melanoma （33.3%, 4 cases） and lent/go maligna melanoma （8.3%, 1 case）. The average Breslow thickness was 1.73mm. Immuno- histochemical stains showed 12 cases （100%） were positive for S-100 and HMB45. Two of three cases with fellow-up data available died of metastatic melanoma within one year. Conclusions The prognosis of primary malignant melanoma of eyelid skin is poor. Tumor thickness, mitotic rate are the most significant powerful predictors. HMB45 and S-100 are helpful for diagnosis.

关 键 词：黑色素瘤 眼睑皮肤 

分 类 号：R739.5[医药卫生—肿瘤]