摘要
目的:分析肛管直肠恶性黑色素瘤( anorectal malignant melanoma,AMM)的临床特点、肠镜表现、病理特点及诊治情况。方法分析四川大学华西医院2009年4月至2014年10月肛管直肠恶性黑色素瘤住院病例共22例。总结患者的病史、临床症状、肠镜表现、实验室检查及诊治情况,统计随访结果并复习文献。结果22例患者中男8例,女14例,男女比例为1:1.75,发病年龄53~79岁,平均发病年龄62.9岁。临床以便血为主诉多见,占86.3%(19/22)。肠镜下表现多样,多为单发或多发隆起物,表面溃烂,部分可有色素沉着。治疗无特效手段,手术切除是AMM目前首选的治疗手段,但对手术方式的选择尚存争议。结论肛管直肠恶性黑色素瘤侵袭性强,临床特点及肠镜表现缺乏特异性,诊治易被延误,早期可发生转移,5年生存率较低;确诊需病理组化。目前国内外尚无AMM的规范诊治指南,临床医师对此病的认识亟待提高。
Objective Analysis the clinical features,colonoscopy performance,pathological features and the diagnosis and treatment of Anorectal malignant melanoma( AMM). Methods Analysis 22 hospitalized cases of AMM from April 2009 to Octo-ber 2014 in West China Hospital of Sichuan University. Summary of the patient's medical history, clinical symptoms,colonoscopy, laboratory examination and treatment,the statistical follow-up results and review of the literature. Result In all 22 cases,14 fe-males,8 males,Male to female ratio was 1:1. 75,Age of onset 53-79 years old,The average Age of onset 62. 9 years old. The main complaint of an AMM patient is not specific. Most chief complaint is bleeding 86. 3%(19/22). Under colonoscopy manifestation, can be single or multiple bumps,with surface ulceration,some may have pigmentation. No special effects of treatment methods,sur-gical resection is now the preferred treatment of AMM,but the choice of surgical approach is controversial. In Conclusion Ano-rectal malignant melanoma( AMM) is a very rare and aggressive disease Clinical characteristics and the performance of the colonos-copy lack of specificity. Susceptible to delays in diagnosisand Early may occurs metastasis. 5-year survival rate is low. Diagnosis requires pathological staining results. Currently there is no standardized treatment guidelines of AMM. Clinician awareness of the disease needs to be improved.
出处
《四川医学》
CAS
2015年第3期286-290,共5页
Sichuan Medical Journal
基金
四川省科技支撑计划(编号:2014SZ0002-2)
关键词
肛管
直肠
恶性黑色素瘤
临床特点
肠镜表现
诊治
anus
rectum
malignant melanoma
clinical characteristics
colonoscopy
diagnosis and treatment