影响原发性肛管直肠恶性黑色素瘤预后的相关因素分析

Relative analysis of prognostic factors in primary anorectal malignant melanoma

目的探讨影响原发性肛管直肠恶性黑色素瘤预后的相关因素。方法回顾性分析27例原发性肛管直肠恶性黑色素瘤患者的诊治及随访情况，对10项观察指标进行单因素分析及多因素分析，单因素分析采用Log-rank检验，多因素分析采用COX回归模型检验。结果单因素分析显示年龄（P=0．048）、肿瘤直径（P=0．001）、浸润深度（P=0．001）、临床分期（P=0．004）、肿瘤转移（P=0．001）与生存期密切相关。多因素分析显示肿瘤直径（P=0．037）、浸润深度（P=0．006）影响原发性肛管直肠恶性黑色素瘤预后。结论肿瘤直径、浸润深度是影响原发性肛管直肠恶性黑色素瘤预后的主要因素。提高生存期的关键是早期诊断、早期治疗。

Objective To investigate the relative analysis of prognostic factors in primary anorectal malignant melanoma （AMM）. Method Twenty-seven patients with AMM were treated, Log-rank and COX analysis were used to find out the relationship of ten factors to survival. Results Log-rank analysis found five of ten factors affecting survival, they were age of patient, diameter of tumor, infiltrated depth, pathological staging and metastasis （P 〈0.05 or 〈0.01 ）, while COX analysis only found the diameter of tumor and infiltrated depth had close relationship to survival （P 〈 0.05 or 〈 0.01 ）. Conclusion The diameter of tumor and infiltrated depth are the main factors affecting the survival of AMM, and this indicates the importance of early diagnosis and treatment.