椎管内原发性黑色素瘤一例报告并文献复习

Intraspinal primary melanoma and the correlation analysis:a case report and review of the literature

目的探讨椎管内原发性黑色素瘤的特点及其相关因素。方法回顾性分析1例椎管内原发性黑色素瘤患者的临床、病理、影像资料及治疗情况，并全面复习相关文献，采用病例报告质量评估清单对纳入文献进行筛选评分。通过收集的病例对此类中枢神经系统罕见肿瘤的人口统计学、病变部位、影像学表现及治疗方法等进行回顾性分析及相关性研究。结果50篇文献共66例（包括本例）椎管内原发性黑色素瘤，男30例，女36例。〈45岁30例，45～60岁15例，〉60岁老年21例。病变位于颈段椎管23例，胸段椎管34例，腰骶段椎管9例（由腰丛、骶丛神经根起源各2例）；脊髓内26例，髓外硬脊膜下35例，硬脊膜外4例，硬膜内外沟通1例。椎管内原发性黑色素瘤发病年龄与性别之间的Pearson χ2检验差异有统计学意义，χ2=6．019，P=0．049；但两者间无相关性，r=0．0213，P=0．085；与病变位置、治疗方法和病变节段之间的Pearson χ2检验差异无统计学意义，也不存在相关性，χ2值分别为3．704、6．365和3．656，r值分别为-0．112、-0．134和0．16，P值均〉0．05。结论椎管内原发性黑色素瘤发病年龄与性别、发病部位等因素间无相关性，但相关临床研究病例数均较少，缺少有力证据支持。

OBJECTIVE To explore the characteristics of spinal primary melanoma and the related factors. METH- ODS The clinical,pathological,imaging data and treatment of 1 case of spinal primary melanoma patient were retrospec- tively analyzed and the relevant literatures were reviewed,the literature was screened and scored by case report quality e- valuation list. Through the literature collection of such rare tumors of the central nervous system,imaging manifestations, treatment and related research were analyzed retrospectively. RESULTS A total of 50 articles 66 cases （including our case） of spinal primary melanoma were taken into research, including 30 cases of male, 36 cases of female, 30 cases of youth, 15 cases of middle-age, 21 cases of elder, the lesion located in the cervical spinal cord in 23 cases,thoracic spinal in 34 cases,lumbar spinal in 9 cases,the lesion located in intramedulla in 26 cases,extramedullary and intradural in 35 cases and epidural in 4 cases,1 cases of epidural internal and external communication. The result of the chi-square test between the age and gender was statistically significant （ χ2= 6. 019, P= 0. 049） ,but there was no correlation between them （r= -0. 0213, P= 0. 085）. The result of the chi-square test between the age and lesion location, treatment methods of spinal primary melanoma was no statistically significant and there was no correlation （χ2 values were 3. 704,6. 365,3. 656 ,r val- ues were --0. 112,-0. 134,0.16,all P〉0. 05）. CONCLUSION No correlation is found between age and gender factors such as location,but the incidence rate is low,the related clinical study is less.