中国人口腔黏膜黑色素瘤临床诊治专家共识  

Expert consensus on clinical diagnosis and treatment for Chinese oral mucosal melanoma

作　　者：郭伟[1] 任国欣[1] 孙沫逸 孔蕴毅 王丽珍[4] 步荣发[5] 冉炜[6] 唐瞻贵[7] 李龙江[8] 孟箭 孙志军[10] 尚伟[11] 吕炯[12] 武和明[13] 张陈平[1] 何悦[1] 马旭辉[1] 宋浩[1] 鞠侯雨 郑家伟[1] 龚忠诚[14] 杨凯[15] 张杰[16] 吴云腾[1] GUO Wei;REN Guo-xin;SUN Mo-yi;KONG Yun-yi;WANG Li-zhen;BU Rong-fa;RAN Wei;TANG Zhan-gui;LI Long-jiang;MENG Jian;SUN Zhi-jun;SHANG Wei;LV Jiong;WU He-ming;ZHANG Chen-ping;HE Yue;MA Xu-hui;SONG Hao;JU Hou-yu;ZHENG Jia-wei;GONG Zhong-cheng;YANG Kai;ZHANG Jie;WU Yun-teng(Department of Oromaxillofacial Head and Neck Oncology,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011;Department of Oral and Maxillofacial Surgery,School of Stomatology,Air Force Medical University,Xi’an 710032;Department of Pathology,Fudan University Shanghai Cancer Center,Shanghai Medical College,Fudan University,Shanghai 200032;Department of Oral Pathology,Shanghai Jiao Tong University School of Medicine,Shanghui 200011;Department of Oral&Maxillofacial Surgery,People’s Liberation Army Hospital,Beijing 100853;Department of Stomatology,First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong Province;Department of Oral and Maxillofacial Surgery,School of Medicine,Central South University,Changsha 410013,Hunan Province;Department of Head and Neck Oncology,West China Stomatological Hospital,Sichuan University,Chengdu 610000,Sichuan Province;Department of Stomatology,Xuzhou Central Hospital,School of Stomatology,Xuzhou Medical University,Xuzhou 221009,Jiangsu Province;Department of Oromaxillofacial Head and Neck Oncology,Hospital of Stomatology Wuhan University,Wuhan 430079,Hubei Province;Department of Oral and Maxillofacial Surgery,Affiliated Hospital of Qingdao University,Qingdao 266000,Shandong Province;Department of Oral and Maxillofacial Surgery,First Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310003,Zhejiang Province;Department of Oral and Maxillofacial Surgery,Nanjing Medical University Stomatology College,College.Nanjing 210008,Jiangsu Province;Department of Oral and Maxillofacial Surgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang Uygur Autonomous Region;Department of Oral and Maxillofacial Surgery,the Firs

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-头颈肿瘤科,上海200011 [2]空军军医大学口腔医学院口腔颌面外科,陕西西安710032 [3]复旦大学附属肿瘤医院病理科,上海200032 [4]上海交通大学医学院附属第九人民医院口腔病理科,上海200011 [5]中国人民解放军总医院口腔科,北京100853 [6]中山大学附属第一医院口腔科,广东广州510080 [7]中南大学湘雅口腔医学院口腔颌面外科,湖南长沙410013 [8]四川大学华西口腔医院头颈肿瘤外科,四川成都610000 [9]徐州医科大学口腔医学院,徐州市中心医院口腔科,江苏徐州221009 [10]武汉大学口腔医学院口腔颌面-头颈肿瘤科,湖北武汉430079 [11]青岛大学附属医院口腔颌面外科,山东青岛266000 [12]浙江大学医学院附属第一医院口腔颌面外科,浙江杭州310003 [13]南京医科大学口腔医学院口腔颌面外科,江苏南京210008 [14]新疆医科大学第一附属医院口腔颌面外科,新疆乌鲁木齐830054 [15]重庆医科大学附属第一医院口腔颌面外科,重庆400042 [16]北京大学口腔医院口腔颌面外科,北京100081

出　　处：《中国口腔颌面外科杂志》2021年第6期481-488,共8页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市科学技术委员会资助项目(14DZ1941400,10410711200,08140902100)。

摘　　要：头颈黏膜黑色素瘤(HNMM)是一类高度恶性的实体肿瘤,5年生存率长期徘徊在20%左右,其致病因素、驱动基因、临床表现及治疗手段等与皮肤黑色素瘤差异较大。2015年,国内首个头颈黏膜黑色素瘤诊治专家共识建立,经过6年多的推广应用,HNMM临床诊治规范性有了很大提高。随着黏膜黑色素瘤临床与基础研究的不断深入,HNMM的诊治与预后在近些年发生了较大变化,特别是头颈部各分支学科的蓬勃发展,口腔、鼻腔鼻窦、眼部等黏膜黑色素瘤各自发展出独特的诊治模式,该共识已不能满足当前临床的实际需求。对此,专家组认为头颈部黏膜包含的解剖范围较广,涉及的临床科室较多,不同学科之间黑色素瘤诊疗模式差异明显,临床亟须符合个体化治疗及精准治疗的更加专科化的诊治共识。为了进一步提高口腔黏膜黑色素瘤(OMM)的远期生存率和生存质量,让共识更好地指导临床工作,专家组聚焦OMM,深入讨论,基于循证医学证据和经验医学,完成专家共识的制定。考虑到患者的个体化差异,本共识可作为OMM临床实践的参考。Head and neck mucosal melanoma(HNMM)is a kind of highly malignant solid tumor.The 5-year survival rate of HNMM is about 20%for a long time.Its pathogenic factors,driving genes,clinical manifestations and treatment methods are quite different from skin melanoma.In 2015,the first Chinese expert consensus on the diagnosis and treatment of head and neck mucosal malignant melanoma was established.After more than six years of application,the clinical diagnosis and treatment of HNMM has been greatly improved.With the deepening of clinical and basic research on mucosal melanoma,the diagnosis,treatment and prognosis of HNMM have changed greatly in recent years,especially with the vigorous development of various branches of head and neck.Oral,nasal,sinus,eye and other mucosal melanoma have developed their own unique diagnosis and treatment model.This consensus can’t meet the actual needs of the current clinical practice.In this regard,the expert group believes that head and neck mucosa contains a wide range of anatomy,involving more clinical departments,and the diagnosis and treatment mode of melanoma varies significantly between different disciplines.It is urgent to meet the clinical consensus of more specialized diagnosis and treatment of individualized treatment and precise treatment.In order to further improve the long-term survival rate and quality of life of oral mucosal melanoma(OMM)and make the consensus to better guide clinical work,this expert group will focus on OMM and conduct in-depth discussion,and establish expert consensus based on evidence-based medicine and empirical medicine.Considering the individual differences of patients,this consensus can be used as a reference for clinical practice of OMM.

关 键 词：口腔 黏膜黑色素瘤 专家共识 

分 类 号：R739.8[医药卫生—肿瘤]