周代超, 刘翠平, 高蕾, 李婧宜, 廖妍, 白岚. 肛管直肠恶性黑色素瘤36例诊治及预后分析[J]. 中国肿瘤临床, 2017, 44(14): 717-721. DOI: 10.3969/j.issn.1000-8179.2017.14.430
引用本文: 周代超, 刘翠平, 高蕾, 李婧宜, 廖妍, 白岚. 肛管直肠恶性黑色素瘤36例诊治及预后分析[J]. 中国肿瘤临床, 2017, 44(14): 717-721. DOI: 10.3969/j.issn.1000-8179.2017.14.430
ZHOU Daichao, LIU Cuiping, GAO Lei, LI Jingyi, LIAO Yan, BAI Lan. Anorectal malignant melanoma: diagnosis, treatment, and prognostic analysis of 36 cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2017, 44(14): 717-721. DOI: 10.3969/j.issn.1000-8179.2017.14.430
Citation: ZHOU Daichao, LIU Cuiping, GAO Lei, LI Jingyi, LIAO Yan, BAI Lan. Anorectal malignant melanoma: diagnosis, treatment, and prognostic analysis of 36 cases[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2017, 44(14): 717-721. DOI: 10.3969/j.issn.1000-8179.2017.14.430

肛管直肠恶性黑色素瘤36例诊治及预后分析

Anorectal malignant melanoma: diagnosis, treatment, and prognostic analysis of 36 cases

  • 摘要:
      目的  分析肛管直肠恶性黑色素瘤(anorectal malignant melanoma,ARMM)患者的临床病理特征及诊治过程,探讨其预后因素及误诊原因。
      方法  回顾性分析2000年1月至2016年11月南方医科大学南方医院、南方医科大学珠江医院、广东省中医院收治的36例ARMM患者的临床资料。
      结果  ARMM临床表现无特异性,误诊率高达52.8%,患者1年和3年生存率分别为75%和35%,中位生存时间为24.51个月。生存率与肿瘤大小、浸润深度、临床分期、淋巴结转移相关,与患者发病年龄、性别无关。单纯手术治疗、采取手术为主的联合治疗、未治疗患者的中位生存时间分别为39.21、26.00、15.00个月,但受病例数所限,其差异无统计学意义;比较经腹会阴联合切除术和广泛性局部扩大切除术患者的生存率差异无统计学意义。
      结论  ARMM预后差,肿瘤大小、浸润深度、临床分期和淋巴结转移是影响预后的因素,手术治疗可延长患者的生存期。因临床易误诊,为尽量避免误诊发生,应做到早诊断、早治疗,对延长患者生存期有重要意义。

     

    Abstract:
      Objective  To analyze the clinicopathological features, diagnosis, and treatment of anorectal malignant melanoma (ARMM), and to explore its prognostic factors and misdiagnosis.
      Methods  A total of 36 patients with ARMM were enrolled in this study from January 2000 to November 2016 in Nanfang Hospital, Zhujiang Hospital, and Guangdong Provincial Hospital of Traditional Chinese Medicine.
      Results  The clinical manifestations of ARMM were not specific. The odds of misdiagnosis were as high as 52.8% in this study. The 1-and 3-year survival rates were 75% and 35%, respectively, with median survival time of 24.51 months. Survival rate was correlated with tumor size, invasion depth, clinical stage, and lymph node metastasis (P < 0.05), but was not related to patient age and gender. The median survival time of the three groups of patients (surgery alone, surgery-based combination therapy, untreated) were 39.21, 26, and 15 months. The difference was not statistically significant. No difference in survival was found between patients undergoing abdominoperineal resection and wide local excision.
      Conclusion  ARMM has poor prognosis and is easily misdiagnosed as a malignant tumor. The prognostic factors are tumor size, invasion depth, clinical stage, and lymph node metastasis. Surgical treatment can extend survival. To avoid misdiagnosis and prolong survival, early diagnosis and early treatment are recommended.

     

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