手术联合小剂量干扰素治疗早期皮肤黑素瘤31例临床分析并文献复习  

Operation Combined with Low-dose Interferon for 31 Patients with Early-stage Malignant Melanoma

作　　者：陈明懿[1] 吴冬梅[1] 杨镓宁[1] 罗东升[1] 应川蓬[1] 戴耕武[1] 

机构地区：[1]四川省人民医院皮肤病性病研究所皮肤外科,四川成都610072

出　　处：《中国皮肤性病学杂志》2017年第6期687-690,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的探讨手术联合小剂量干扰素治疗早期皮肤黑素瘤的临床疗效和安全性。方法回顾本科2007年4月-2011年3月收治的早期皮肤黑素瘤患者的临床资料。结果 31例患者中,男17例,女14例;年龄42~77岁,病程3个月~6年,术前均未见局部淋巴结转移或远处转移灶,临床上属Ⅰa~Ⅱc期,予皮损扩大切除(或截肢)加植皮或皮瓣修复术联合小剂量干扰素(300万U,3次/周)治疗18个月后,21例切口愈合良好,随访5年无复发,肿瘤厚(2.11±0.86)mm。10例于术后4~25个月时复发,其中1例Ⅱa期,6例Ⅱb期,3例Ⅱc期,肿瘤厚(3.62±1.16)mm。4例因黑素瘤转移死亡,其中1例Ⅱb期,3例Ⅱc期。27例存活患者中有1例白细胞下降显著而停止干扰素注射。总生存率87.10%,无病生存期44.1个月,5年无复发生存率67.74%。结论手术切除联合干扰素治疗早期皮肤黑素瘤预后尚可,与术后联合大剂量干扰素相比,疗效相似,且不良反应相对较轻,患者的依从性高,但是疗效可能受肿瘤的病理类型、厚度和分期影响。Objective To observe the therapeutic results of operation combined with low-dose INF-u-2b for early-stage malignant melanoma （MM）. Methods From April 2007 to March 2011,31 patients with M M were treated in our department. There were 17 males and 14 females, aging from 42 to 77 years old. The disease course was 3 months to 6 years. All the patients were excluded adjacent lymphonode affected or metastasis. All patients were identified as TNM I or Ⅱ stage, and received enlarge-section or amputation, then were treated with low-dose INF-u-2b （3 MIU, thrice per week, lasted for 18 months）. Results Twenty-one patients recovered well with no recurrence after 5 years＇ observation, staging Ⅰa Ⅱ b,with tumor thickness （2. 11 ± 0. 86） mm. Ten patients were found recurrences 3 months to 2 years after operation, staging Ⅱ a - Ⅱ c, with tumor thickness（3.62 ± 1.16）mm. Four patients died in 6 - 12 months after operation due to the metastasis. A- mong the survived 27 patients, only one could not tolerate the adverse reaction of INF. Overall survival rate was 87.10% , disease free survival time was 44. 1 months, relapse-free survival rate was 67. 74%. Conclusion It＇s an effective method to treat early-stage malignant melanoma with operation combined with low-dose INF-u-2b. Compared with high-dose IFN after operation, this method had the similar therapeutic effect and lower-risk of toxicity. But the result may depends on several factors, such as the pathological type, thickness and clinical stage of the tumor.

关 键 词：黑素瘤 手术 干扰素 组织病理 

分 类 号：R739.5[医药卫生—肿瘤]