促纤维组织增生性黑色素瘤的研究

A Retrospective Study of Desmoplastic Melanoma

目的：研究促纤维组织增生性黑色素瘤的生物学行为与病理学特性。方法：收集我院1987年—2006年收诊的病例及复习文献[1]共47例,采用石蜡切片,HE染色及免疫组织化学S-P法染色。结果：促纤维组织增生性黑色素瘤是一种低度恶性肿瘤,好发于老年人（42-91）岁,平均71岁,男女之比31：16。随访中生存时间最短的一例,于术后3个月因第V对、第VII对颅神经转移而死亡,最长一例从发病到死亡经过了35年时间。肿瘤多位于皮下或深部软组织,常无良好包膜,分界欠清。梭形细胞较多,围以硬化的间质,肿瘤细胞可非常稀少,常表达S100,HNB45,Desmin。结论：促纤维组织增生性黑色素瘤,低度恶性,呈侵袭性生长,很少转移,单纯手术切除,预后良好,但局部可以复发。肿瘤细胞呈梭形或不规则形,表达S100,HMB45,Desmin。

Objective：To explore the biology behavior and pathology characteristic of the desmoplastic melanoma.Methods：We collected 47 case of desmoplastic melanoma between 1987 and 2006 in our hospital and reviewed these sample documents.The samples were dealt,in proper order,with paraffin wax slice,the HE dyeing and the S-P immununohistochemstry dyeing.Results：We found that desmoplastic melanoma is a low degree malignancy to occur in the elderly,and the ages ranged from 42 to 91 years old,average 71 years old;men versus women in a ratio of 31：16.Dead was one case after 3 months surgical operation because tumor transfers to the V and VII cranial nerves.Specially,one case survived for 35 years.Moreover,the tumor locates subcuticular or deeply soft tissue commonly,tumors often without a good coating,boundary less clear and spindle cells were enclosed by a sclerotic stroma and the tumor cells are very rare.The tumor cells often express S100,HMB45,Desmin.Conclusions：The desmoplastic melanoma is a low grade tumor.The tumors appear aggressive,seldom metastasize,and the pure operative cut off and good prognosis.The tumor expresses as S100,HMB 45,Desmin.