肛管直肠恶性黑色素瘤的临床病理特征及预后分析  

Clinicopathological characteristics and prognosis of anorectal malignant melanoma

作　　者：李吉云 程璞 黄飞 田若曦 陈海鹏 郑朝旭 Li Jiyun;Cheng Pu;Huang Fei;Tian Ruoxi;Chen Haipeng;Zheng Zhaoxu(Department of Colorectal Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心、国家肿瘤临床医学研究中心、中国医学科学院北京协和医学院肿瘤医院结直肠外科,北京100021

出　　处：《中华普通外科杂志》2023年第2期96-100,共5页Chinese Journal of General Surgery

基　　金：中国癌症基金会北京希望马拉松专项基金(LC2021A23)。

摘　　要：目的探讨肛管直肠恶性黑色素瘤(anorectal malignant melanoma,ARMM)的临床病理特征及其对预后的影响。方法收集2012年4月至2022年4月在中国医学科学院肿瘤医院结直肠外科接受手术治疗的40例ARMM患者的临床病理资料,采用Kaplan-Meier生存分析和多因素COX比例风险模型分析不同临床病理因素及治疗方式对ARMM患者总生存期的影响。结果在40例ARMM患者中男16例,女24例,中位发病年龄为61岁。所有患者中位随访时间为47(25~69)个月,中位生存期为19(15~23)个月,1年生存率和3年生存率分别为74.3%和21.7%。接受局部扩大切除术和腹会阴联合切除术两组患者的生存期差异无统计学意义(χ^(2)=1.281,P=0.258)。单因素分析显示,ARMM患者总生存期与肿瘤直径、浸润深度、标本切缘及淋巴结转移(χ^(2)=1.281,P=0.039;χ^(2)=3.760,P=0.042;χ^(2)=6.581,P=0.010;χ^(2)=21.683,P<0.001)均有关,多因素分析提示淋巴结转移为ARMM患者总生存期的独立危险因素。结论肿瘤直径、浸润深度、标本切缘及淋巴结转移是ARMM重要的预后影响因素,淋巴结转移是ARMM患者总生存期的独立危险因素。Objective To investigate the impact of the clinicopathological characteristics of anorectal malignant melanoma(ARMM)on the prognosis.Methods The clinicopathological data of 40 ARMM patients undergoing surgery at the Department of Colorectal Surgery,Cancer Hospital,Chinese Academy of Medical Sciences from Apr 2012 to Apr 2022 were collected,and the impact of different clinicopathological factors and treatment modalities on the overall survival of ARMM patients was investigated using Kaplan-Meier survival analysis and multifactorial Cox proportional risk model analysis.Results Among 40 ARMM patients,16 were male and 24 were female.The median age of onset was 61 yr.The median follow-up period for all patients was 47(25-69)months,with a median survival of 19(15-23)months and 1-year and 3-year survival rates of 74.3%and 21.7%,respectively.There was no statistically significant difference in survival time between the two groups of patients receiving wide local excision and abdominoperineal resection(χ^(2)=1.281,P=0.258).Univariate analysis showed that overall survival in patients with ARMM was related to tumour diameter,depth of infiltration,specimen margin and lymph node metastasis(χ^(2)=1.281,P=0.039;χ^(2)=3.760,P=0.042;χ^(2)=6.581,P=0.010;χ^(2)=21.683,P<0.001),and multivariate analysis suggested that lymph node metastasis was an independent risk factor for overall survival in patients with ARMM.Conclusion Tumour diameter,depth of infiltration,specimen margin and lymph node metastasis were important prognostic influences in ARMM,and lymph node metastasis was an independent risk factor for overall survival in ARMM patients.

关 键 词：黑色素瘤 肛管 病理学 临床 预后 

分 类 号：R735.38[医药卫生—肿瘤]