40例原发性粘膜恶性黑色素瘤临床病理分析

Clinicopathologic analysis of 40 cases of primary melanoma of mucous membranes

目的：观察粘膜黑色素瘤的临床及病理形态学特点并探讨其组织发生。方法：对４０例粘膜黑色素瘤进行光镜观察，并对部分病例作组化及免疫组化染色。结果：４０例粘膜恶黑中，发生于鼻腔１６例，肛管直肠８例、口腔７例、眼结膜４例、阴道２例、鼻咽部、宫颈及尿道各１例。发病年龄３３～７５岁（平均５７岁）。镜下改变与皮肤黑色素瘤类似。免疫组化染色Ｓ－１００阳性率为９５％，ＨＭＢ４５为９０％。结论：粘膜黑色素瘤的临床病理特点及抗原表达情况与皮肤黑色素瘤的无明显区别。粘膜黑痣及粘膜上皮的黑色素细胞是粘膜黑色素瘤发生的基础。

Purpose To investigate the clinicopathological characteristics and histogenesis of primary melanoma of the mucous membranes. Methods Forty cases of primary melanoma were investigated at the light microscopic level. Some cases were studied by histochemical and immunohistochemical techniques. Results The age of 40 patients with primary melanom of the mucons membranes ranged from 33 to 73 years (mean 57 years). Of these cases, 16 were located in the nasal cavity, 8 the anus and rectum, 7 the oral cavity, 4 the conjunctiva, 2 the vagina, 1 each the nasophargngea, the cervix and the urethra. The histopathological features of primary melanoma of the mucous membranes were similar to those of the skin. The postivity rates of the expressions of S 100 and HMB 45 in 20 cases of primary melanoma of the mucous membranes were 95% and 90% respeetively. Conclusions No significant differences in the clinicopathogical features and characteristics of the expression of antigens were observed between the primary melanoma of the mucous membranes and that of the skin. The melanotic nevi and melanocytes in the mucous membrane epithelium may be the bases of the occurrence of primary melanoma of the mucous membranes.