Ⅰ期皮肤黑素瘤163例临床病理特征及预后分析  

Analysis of clinicopathological features and prognosis of 163 cases of stageⅠcutaneous melanoma

作　　者：张晓[1] 陈凤鸣[1] 柳琳[1] 罗莉[1] 郭金 高天文[1] 石琼[1] Zhang Xiao;Chen Fengming;Liu Lin;Luo Li;Guo Jin;Gao Tianwen;Shi Qiong(Department of Dermatology,Xijing Hospital,The Fourth Military Medical University,Xi′an 710032,China)

机构地区：[1]第四军医大学西京皮肤医院,西安710032

出　　处：《中华皮肤科杂志》2022年第5期389-394,共6页Chinese Journal of Dermatology

摘　　要：目的分析Ⅰ期皮肤黑素瘤患者的临床特点、病理特征及预后情况。方法收集西京皮肤医院2010年1月至2020年1月收治的163例Ⅰ期皮肤黑素瘤患者资料,回顾性分析临床特点、病理特征、治疗方法及预后。结果163例Ⅰ期皮肤黑素瘤患者就诊中位年龄53岁,男56例(34.36%),女107例(65.64%)。原发皮损位于肢端104例(63.80%),其中位于指(趾)甲39例,肢端其他部位65例;皮损位于日光暴露部位如头面部29例(17.79%),非日光暴露部位如躯干、四肢(除手足外)30例(18.40%)。56例(34.36%)病理诊断为ⅠA期,107例(65.64%)ⅠB期。病理分型:肢端雀斑样黑素瘤104例(63.80%),浅表扩散性黑素瘤23例(14.11%),结节性黑素瘤15例(9.20%),恶性雀斑样痣黑素瘤14例(8.59%),其他少见或难以确定分型者7例(4.29%)。163例患者均行至少1次手术治疗,其中截指(趾)15例,扩大切除94例,切除(未扩大)54例;切除的54例患者中,35例行二次手术,其中33例行扩大切除,2例截指。7例患者术后发生淋巴结和/或远处脏器转移,其中2例远处脏器转移后死亡。163例患者5年生存率为98.00%。结论Ⅰ期皮肤黑素瘤整体预后较好,但也有术后发生淋巴结、远处脏器转移的病例,提示应加强长期跟踪随访及对转移患者的早期干预。Objective To analyze clinical manifestations,pathological features and prognosis of patients with stageⅠcutaneous melanoma.Methods Clinical data were collected from 163 patients with stageⅠcutaneous melanoma in Department of Dermatology,Xijing Hospital from January 2010 to January 2020,and clinical manifestations,pathological features,treatment methods and prognosis were retrospectively analyzed.Results Among the 163 patients with stageⅠcutaneous melanoma,56(34.36%)were males,and 107(65.64%)were females,with a median age of 53 years at the clinic visit.Primary skin lesions were most frequently located on the extremities in 104 cases(63.80%),of which 39 presented with lesions on the finger or toe nails and 65 with lesions on the other parts of the extremities;skin lesions were located at sun-exposed sites such as the head and face in 29(17.79%)cases,and at non-sun-exposed sites such as the trunk and extremities except the hands and feet in 30(18.40%).Of the 163 patients,56(34.36%)were pathologically diagnosed with stageⅠA cutaneous melanoma,and 107(65.64%)with stageⅠB cutaneous melanoma.According to a pathological staging system,104(63.80%)patients suffered from acral lentiginous melanoma,23(14.11%)superficial spreading melanoma,15(9.20%)nodular melanoma,14(8.59%)malignant lentigo-maligna melanoma,and 7(4.29%)other rare or difficult-to-determine types.All the 163 patients received surgical treatment at least once,of whom 15 underwent finger or toe amputation,94 extended resections,and 54 unextended resections;35 received secondary surgeries,of whom 33 underwent extended resections and 2 finger amputation.Seven patients developed postoperative lymph node and/or distant organ metastases,2 of whom died after distant organ metastases.The 5-year survival rate of the 163 patients was 98.00%.Conclusion StageⅠcutaneous melanoma commonly has favorable prognosis,and 7 patients developed postoperative lymph node and/or distant organ metastases in this study,suggesting that long-term follow-up of patients with acr

关 键 词：黑色素瘤 治疗 预后 临床病理特征 

分 类 号：R739.5[医药卫生—肿瘤]