350例皮肤恶性黑色素瘤的病理形态学观察和预后分析——附酶化学、电镜和免疫酶标在诊断中的作用

THE CLINICAL AND PATHOLOGICAL OBSERVATIONS ON 350 CASES OF CUTANEOUS MALIGNANT MELANOMA

皮肤恶性黑色素瘤(以下简称恶黑)是一种高度恶性肿瘤。由于发病比较隐匿,部位分布广泛,组织结构变化多端,转移途径较为奇特.

350 cases of cutaneous malignant melanoma(MM)collected from November 1956 toFebruary 1982 were observed and analysed with special emphasis on the pathologicalchanges of the primary MM.The follow--up rate was 92.15%.Seven laboratory methods were evaluated.It was suggested that Prussian blue reaction,melanin bleaching test and Masson-Fontana’s silver staining were helpful for confirmingthe presence of melanin in the tumor cells;reticulin staining was useful in distinguishingbenign nevus from MM;while Dopa--oxidase reaction,electron microscopic study andimmunoenzyme labelling method play an important role in the diagnosis of amelanoticmelanoma.The results calculated by Life--Table method on the follow-up data showed that the 3year survival rate(51.58±3.29%)was used to serve as the index for the assessment ofprognosis.According to the results from both single factor and stepwise regression analyses,the significant influencing factors on prognosis were the size and thickness of the tumor,clinical staging,the histological types,level of invasion,mitoses,vascular invasion andulceration,etc.in addition to metastasis and recurrence.