结膜恶性黑色素瘤17例临床分析

Clinical analysis of conjunctival chromoma in 17 patients

目的探讨结膜恶性黑色素瘤的临床特点及其治疗和预后。方法对我院眼科经病理确诊为结膜恶性黑色素瘤的17例患者中10例(仅累及球结膜、穹隆结膜、睑结膜者7例,同时累及3者的3例)行局部病变切除手术;病变累及眼睑皮肤、睑缘及角膜者7例,其中2例行眶内容物摘除术,2例合并肺转移及颅内转移者未手术,3例放弃手术治疗。随访1～6a,平均36个月,对随访及患者临床资料行回顾性分析。结果17例结膜恶性黑色素瘤,预后相对较差,痊愈2例(11.76%),局部复发8例(47.05%),死亡7例(41.17%)。结论结膜恶性黑色素瘤的预后与肿瘤厚度、解剖部位、累及范围、首次治疗方案等有关,早期诊断和选择最佳治疗方案是改善生存质量的重要手段。

Objective To evaluate the clinical characteristics and prognosis in patients with conjunctival chromoma.Methods Seventeen patients with conjunctival chromoma,which had been confirmed by pathology at our hospital,were studied.Ten patients（7 involved with either conjunctiva of eyeball,fornix or eyelid;3 involved with all of these）had to carry out localized operation;Seven patients involved with skin of eyelid and cornea,2 patients of which received eye exenteration,another 2 patients didn’t receive operation because the patients happened lung metastasis and intracranial metastasis,and the other 3 patients abandoned treatment.All cases were followed up for 1 to 6 years（average time was 36 months）.Following-up and medical records were retrospectively analyzed.Results There were two people recovered（11.76%）;8 patients recurred（47.05%）;7 patients died（41.17%）.The prognosis was not good.Conclusion The prevention of conjunctival chromoma associates with knubbly size,anatomic site,range of involvement and primary treatment.Early diagnosis and selecting optimal treatment are the most powerful tools for improving quality of life.