局部切除术联合冷冻治疗结膜恶性黑色素瘤生存率分析  

Analysis on survival rate in local resection combined with cryotherapy for treating conjunctival malignant melanoma

作　　者：石安杰 杨玉琼 李佳 郝冰 李秀红 袁洪峰 SHI Anjie;YANG Yuqiong;LI Jia;HAO Bing;LI Xiuhong;YUAN Hongfeng(Department of Ophthalmology,Army Characteristic Medical Center,Chongqing 400042,China)

机构地区：[1]陆军特色医学中心眼科,重庆400042

出　　处：《重庆医学》2021年第13期2269-2273,2282,共6页Chongqing medicine

摘　　要：目的研究局部切除术联合冷冻治疗结膜恶性黑色素瘤的生存率及预后因素。方法回顾性研究2003年7月至2018年1月该院眼科诊治的26例结膜恶性黑色素瘤病例资料和临床病理特点,分析局部切除联合冷冻治疗结膜恶性黑色素瘤的预后因素。结果26例患者5年总体生存率、复发率、转移率分别为56.7%、68.5%、52.4%。随着临床分期的增加,患者5年生存率明显降低(χ^(2)=9.531,P=0.009),T1期、T2期和T3期的生存率分别为85.1%、54.5%、50.0%。与其类似,随着肿瘤厚度增加,生存率明显降低(χ^(2)=4.644,P=0.031),肿瘤厚度<2.0 mm与≥2.0 mm的生存率分别为87.5%、36.5%。肿瘤侵犯泪阜与否(χ^(2)=1.694,P=0.193)和组织病理学特点(χ^(2)=3.336,P=0.189)差异无统计学意义。结论结膜恶性黑色素瘤分期和厚度与患者预后明显相关,早期诊断及治疗可明显提高患者生存率。Objective To study the survival rate and prognostic factors of local resection combined with cryotherapy in treating conjunctival malignant melanoma.Methods The medical data and clinicopathological characteristics in 26 cases of conjunctival malignant melanoma in the ophthalmology department of this hospital from January 2004 to January 2018 were retrospectively studied.The prognostic factors of local resection combined with cryotherapy for treating conjunctival malignant melanoma were analyzed.Results The overall 5-year survival rate,recurrence rate and metastasis rate of 26 cases were 56.7%,68.5%and 52.4%respectively.With the increase of clinical stage,the 5-year survival rate was significantly decreased(χ^(2)=9.531,P=0.009),the survival rates of the stage T1,T2 and T3 were 85.1%,54.5%and 50.0%respectively.Similarly,with the increase of tumour thickness,the survival rate was decreased significantly(χ^(2)=4.644,P=0.031),the survival rates of tumor thickness≥2.0 mm and<2.0 mm were 36.5%and 87.5%,respectively.However,there was no statistically significant difference between lacrimal caruncle involvement(χ^(2)=1.694,P=0.193)and histopathological features(χ^(2)=3.336,P=0.189).Conclusion The stage and thickness of conjunctival malignant melanoma are significantly correlated with the prognosis.Early diagnosis and treatment can significantly improve the survival rate.

关 键 词：手术治疗 恶性黑色素瘤 局部切除术 结膜 生存率 预后因素 

分 类 号：R777.3[医药卫生—眼科]