52例原发性口腔黏膜恶性黑色素瘤的临床分析  

Clinical analysis on 52 cases of primary oral mucosal melanoma

作　　者：杨溪[1] 张安玲[2] 张陈平[1] 钟来平[1] 郭伟[1] 任国欣[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院口腔颌面外科,上海200011 [2]吉林大学第四医院口腔科,130011

出　　处：《临床肿瘤学杂志》2011年第10期882-886,共5页Chinese Clinical Oncology

基　　金：上海市科委科技发展基金资助项目(08140902100);上海交大"医工(理)交叉"研究基金资助项目(YG2009MS13)

摘　　要：目的探讨影响原发性口腔黏膜恶性黑色素瘤临床预后的相关因素。方法收集2004年1月至2010年1月52例原发性口腔黏膜恶性黑色素瘤患者的临床病理资料,采用Kaplan-Meier法分析临床病理因素与预后的关系。结果 52例患者中,42例T3患者的平均生存时间为48.4个月,10例T4a患者为11.3个月,差异有统计学意义(P<0.001);32例N0患者的平均生存时间为50.0个月,20例N1患者为29.8个月,差异有统计学意义(P=0.004);17例Ⅲ期患者的平均生存时间为55.9个月,35例Ⅳ期患者为34.8个月,差异有统计学意义(P=0.007);40例接受化疗的患者平均生存时间为47.8个月,而未接受化疗者为19.0个月,差异有统计学意义(P=0.01)。口腔黏膜恶性黑色素瘤的临床分期、化疗与否及综合治疗方案均与预后相关,而原发灶的处理方式、颈淋巴结清扫术与预后无关。结论口腔黏膜恶性黑色素瘤治疗提倡综合序列治疗,化疗为主要的辅助治疗手段,可以延长患者的生存时间。Objective To access the outcome and identify clinical prognostic factors in a recent cohort of patients with primary oral mucosal melanoma.Methods The clinical records of 52 patients with diagnosis of primary oral mucosal melanoma from January 2004 to January 2010 were retrospectively reviewed.Clinical factors were analyzed for the impact on outcomes by Kaplan-Meier test.Results In the 52 patients,the average survival of 42 cases of T3 was 48.4 months,while that of 10 cases of T4apatients was 11.3 months（P0.001）.The survival of 32 cases of N0 was 50.0 months,while that of 20 N1 patients was 29.8 months（P=0.004）.Seventeen patients of stage Ⅲ had the average 55.7 months survival,and 35 patients of stage Ⅳ got the average 34.8 months survival（P=0.007）.Forty cases treated with chemotherapy has the average survival time of 47.8 months,and 12 cases without chemotherapy got the average 19.0 months survival time（P=0.01）.Tumor stage,whether receiving chemotherapy and systemic therapy were correlated to prognosis（P0.05）,while focis dealing method and neck dissection had no correlation with the prognosis.Conclusion Oral mucosal malignant melanoma should be applied with comprehensive and sequential therapy.Chemotherapy is a major adjacent treatment,which can lengthen survival.

关 键 词：口腔黏膜 恶性黑色素瘤 化学治疗 综合序列治疗 

分 类 号：R739.8[医药卫生—肿瘤]