皮肤转移性恶性肿瘤的临床病理特征及预后影响因素分析

Analysis of clinicopathological features and prognostic factors in cutaneous metastases of malignant tumors

目的探讨皮肤转移性恶性肿瘤的临床病理特征及影响预后的因素。方法回顾性分析2006年1月至2013年2月收治的48例皮肤转移性恶性肿瘤患者的临床资料,用Kaplan-Meier法和Cox模型分析影响预后的因素。结果皮肤转移恶性肿瘤好发于躯干部,主要为单个或多个结节与肿块;男性最常见的原发肿瘤为肺癌和结肠癌,其次为食管癌和胃癌,易转移至腹部、胸部;女性多为乳腺癌,易转移至胸部。皮肤转移性恶性肿瘤的病理类型以腺癌(35/48)和鳞癌(7/48)为主。至随访截止时间,20例患者死亡,12例失访,16例仍存活,中位总生存时间为17.0个月。生存分析显示,有无综合治疗、有无其他脏器转移是影响预后的独立因素。结论出现皮肤转移的恶性肿瘤患者预后差,同时合并其它器官转移者的生存时间更短,合理有效的综合治疗仍可减轻症状,延长患者的生存期,并提高生活质量。

Objective To analyze the clinicopathological features in cutaneous metastases of malignant tumors and explore the prognostic factors. Methods The clinicopathological data, treatment and follow-up data of 48 patients with metastatic cutaneous tumors admitted by the third affiliated hospital of Soochow University from January 2006 to February 2013 were collected and retrospec- tively analyzed. The prognostic factors were analyzed by univariate analysis and Cox multivariate analysis. Results Metastatic cutane- ous tumors mainly occur in the trunk, as a single or multiple nodules and masses. The primary tumor in males mostly located in lung and colon, followed by the esophagus and stomach, and prone to metastasis to chest and abdomen. In contrast, the primary in females mostly located in breast, which were apt to metastasis to the chest. The main pathological types of metastatic cutaneous tumors were ad- enocarcinoma（35/48） and squamous cell carcinoma（7/48）. At end of follow-up, 20 patients died, 12 cases lost and 16 cases sur- vived. The medium survival time was 17. 0 months. The prognostic factors were with or without combined therapy and other organ metas- tasis. Conclusion The prognosis in the patients with skin metastasis was poor. Other organ metastases could shorten the patients＇ sur- vival times. Therefore, reasonable, effective and comprehensive treatment could alleviate the symptoms, prolong the survival times and improve the quality of life.