食管恶性黑色素瘤6例临床分析  

Clinical analysis of 6 cases of malignant melanoma of the esophagus

作　　者：刘庆浩[1] 龙志强[1] 黄伟明[1] 商学谦[1] 李简[1] LIU Qinghao;LONG Zhiqiang;HUANG Weiming;SHANG Xueqian;LI Jian(Department of Thoracic Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院胸外科,北京100034

出　　处：《中国医药导报》2018年第23期109-112,共4页China Medical Herald

摘　　要：目的探讨食管恶性黑色素瘤的临床特征、诊断、治疗和预后。方法回顾性分析2013年1月~2017年5月北京大学第一医院收治的6例食管恶性黑色素瘤患者的临床资料,并对所有患者进行随访。结果 6例患者,平均年龄57.7岁,其中男4例,女2例。肿瘤位于中段2例、下段4例。内镜活检误诊2例,确诊需结合病理切片和免疫组化。6例均接受手术治疗,1例单纯手术治疗,5例行术后辅助治疗。术后病理分期,Ⅰ期2例,Ⅱ期3例,Ⅲ期1例。其中1例术后21个月行肺转移瘤切除,术后60个月随访存活。患者生存时间8~60个月,中位生存期18个月。结论食管恶性黑色素瘤是一种罕见高度侵袭性的恶性肿瘤,早期诊断和早期治疗可以改善预后,经过严格挑选的病例,转移瘤的切除也有生存获益。免疫靶向治疗的进展,能改善更多患者的预后,值得进一步研究。Objective To investigate the clinical features, diagnosis, treatment and prognosis of malignant melanoma of the esophagus. Methods Clinical data of 6 patients with malignant melanoma of the esophagus admitted to Peking University First Hospital from January 2013 to May 2017 were retrospectively analyzed and all patients were followed up.Results The average age of the 6 patients was 57.7 years old, 4 males and 2 females. There were 2 cases in the middle segment of the esophagus and 4 cases in the lower part of the esophagus. There were 2 cases misdiagnosed by endoscopic biopsy, and definite diagnosis need pathological section and immunohistochemistry method. All the 6 cases undertwent surgery, 1 case undertwent surgery alone, and 5 cases received postoperative adjuvant therapy. They were divided by postoperative pathological stage, 2 cases in stage Ⅰ, 3 cases in stage Ⅱ, and 1 case in stage Ⅲ. Among them, 1 case underwent resection of pulmonary metastases 21 months after operation, and the case was followed up for60 months after operation. The survival time was 8 to 60 months, and the median survival time was 18 months. Conclusion Malignant melanoma of the esophagus is a rare and highly invasive malignant tumor. Early diagnosis and early treatment can improve the prognosis. Strictly selected PMME patients with isolated/localized, and removal of metastatic tumors has survival benefits. The progress of immune-targeted therapy can improve the prognosis of more patients, which is worthy of further study.

关 键 词：食管 恶性黑色素瘤 手术 预后 

分 类 号：R735[医药卫生—肿瘤]