原发性和继发性颅内恶性黑色素瘤临床特征及预后分析  

Analysis on the clinical features and prognosis of primary and secondary intracranial malignant melanoma

作　　者：焦贺男 闫东明[1] JIAO He′nan;YAN Dongming(Department of Neurosurgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经外科,河南郑州450052

出　　处：《中国现代医生》2022年第17期19-23,F0003,共6页China Modern Doctor

摘　　要：目的 探讨原发性和继发性颅内黑色素瘤的诊断方式、临床特点、治疗方法 及其预后。方法 回顾性分析2003年1月~2020年1月于郑州大学第一附属医院收治的26例颅内黑色素瘤患者资料,描述肿瘤临床特征及影像特点,随访患者的治疗效果及预后情况。结果 原发性黑色素瘤(PIMM)和继发性黑色素瘤(MIMM)临床表现以颅内压增高和肿瘤占位效应多见,两者多好发于额叶,T1WI高信号,T2WI低信号18例;T1WI等信号、T2WI高信号6例;混杂信号2例。增强扫描呈不均匀强化。出血性肿瘤在预后单因素分析中,差异有统计学意义(P<0.05)。PIMM术后平均生存时间为(18.69±1.99)个月(95%CI:12.611~25.389),MIMM手术后平均生存时间为(20.14±2.20)个月(95%CI:14.369~21.631),差异无统计学意义(P=0.991>0.05)。结论 颅内黑色素瘤影像学表现以T1WI高信号,T2WI低信号多见,病理诊断为金标准。PIMM和MIMM患者术后生存期无明显差别,预后均较差,两者首选手术治疗且术后配合放、化学治疗。Objective To investigate the diagnosis method,clinical features,treatment and prognosis of primary and secondary intracranial melanoma.Methods The data of 26 patients with intracranial melanoma treated in the First Affiliated Hospital of Zhengzhou University from January 2003 to January 2020 were retrospectively analyzed.The clinical and imaging features of the tumor were described,and the treatment effect and prognosis were followed up.Results The clinical manifestations of primary intracranial malignant melanoma(PIMM)and metastatic intracranial malignant melanoma(MIMM)were mainly increased intracranial pressure and space-occupying effects of tumor.They mostly occurred in the frontal lobe.High signal on T1-weighted imaging(T1WI)and low signal on T2-weighted imaging(T2WI)were observed in 18 cases;equal signal on T1WI and high signal on T2WI in 6 cases;mixed signal in 2 cases.The enhanced scan showed uneven enhancement.There was a statistical significance in the hemorrhagic tumors according to the univariate analysis of prognostic factors(P<0.05).The mean survival time after PIMM was(18.69±1.99)months(95%CI:12.611-25.389),and that after MIMM was(20.14±2.20)months(95%CI:14.369-21.631),without statistically significant difference(P=0.991>0.05).Conclusion The imaging manifestations of intracranial melanoma are mainly high signal on T1WI and low signal on T2WI.The pathological diagnosis is the gold standard.There is no significant difference in postoperative survival time between PIMM and MIMM patients,and the prognosis is poor.For the two types,surgical treatment is the first choice,and postoperative radiotherapy should be combined with chemotherapy.

关 键 词：颅内黑色素瘤 转移 治疗 预后 

分 类 号：R739.5[医药卫生—肿瘤]