日本福岗地区黑素瘤的临床及预后分析(附72例报告)

Clinical and prognosis analysis of 72 cases with malignantmelanoma in Hukuoka,Japan

目的 :探讨黑素瘤 (MM)的发病部位、性别、年龄、临床病理分型、组织浸润程度、淋巴结转移程度与预后的关系。方法 :回顾 1982～ 1996年日本九州大学医院部皮肤科住院治疗的 MM患者 72例 ,分析其一般资料、前驱病变、临床病理分型、TNM分类以及目前状态。结果 :发生于躯干、下肢、粘膜部位的 MM其病死率最高 ,面及足部者次之 ,上肢及手部者最低 ;结节型黑素瘤 (NM)的病死率高于其他各型 (P<0 .0 5 ) ;年龄越大其病死率越高 ;组织浸润程度与病死率呈正相关 ;有脏器转移者其病死率最高 (90 .9% ) ,转移淋巴结超过 3cm或有卫星灶者其病死率高于无淋巴结转移或有淋巴结转移但小于3cm者 (P<0 .0 1)。结论 :发生于躯干、下肢及粘膜部位的 MM、NM、侵犯至皮下组织或有卫星灶的MM、转移淋巴结超过 3cm或有脏器转移者 ,其病死高 。

Objective:To investigate the relation between site,sex,age,pathological type,degree of infiltration,degree of lymphatic metastasis and prognosis of malignant melanoma (MM).Methods:Histologic slides of 72 cases of MM from 1982 to 1996 in Department of Dermatology,Kyushu University Faculty of Medicine were retrospectively reviewed.The general data,premonitory lesion,pathological type,TNM classification and present state were analyzed.Results:Fatality rate of MM occurrence on body,lower limb,mucose was the highest;that on face and feet the second;that on upper limb and hand the lowest.Fatality rate of nodular melanoma (NM) was higher than that of other types ( P <0 05);the older the age,the higher the fatality rate;degree of the tissue infiltration showed positive correlation with the fatality rate;fatality rate with organ metastasis was the highest (90.9%);fatality rate of the cases in whom the size of the transferred lymphatic node was over 3 cm or who with satellite foci was higher than that of no lymphatic metastasis or that with lymphatic metastasis but the size smaller than 3 cm ( P <0 01).Conclusion:For MM occurrence on body,mucose and lower limb,NM,MM infiltration subcutaneous tissue or MM with satellite foci,MM with lymphatic metastasis and the size over 3 cm or with organ metastasis,the fatality rate is high,which should be paid more attention to.