39例皮肤黑素瘤临床病理分析

Clinical and histopathological analysis of 39 cases of cutaneous melignant melanoma

目的 探索皮肤黑素瘤的临床和组织病理特点。方法 回顾性分析（2008-2015）年昆明医科大学第一附属医院皮肤科确诊的39例皮肤恶性黑素瘤临床特点及组织病理学特点,并进行Clark（1969）分级。结果 39例皮肤恶性黑色素瘤中男性患者15例（38.5%）,女性24例（61.5%）;发病年龄在（17-84）岁之间,平均年龄（58.5±12.5）岁;发病部位肢端31例（79.5%）,面部6例（15.3%）,背部及左膝关节各1例（2.6%）;出现溃疡者17例（43.6%）,无溃疡者22例（56.4%）;临床与病理诊断符合病例数31例,占统计病例79.5%;免疫组化染色结果示S-100（＋）27例（69.23%）,HMB-45（＋）28例（71.79%）,Melanin-A（27）例（69.23%）,Ki-67（＋）24例（61.54%）。结论 皮肤黑素瘤发病年龄以中老年为主,肢端部位好发,斑疹侵袭深度为II级及以下,斑块、结节及溃疡侵袭深度为III级及以上。

Objective To analysis the clinical and pathological characteristics of 39 cases of cutaneous melignant melanoma. Methods To analyze clinical and pathological characteristics of 39 patients with cutaneous malignant melanoma diagnosed at the Department of Dermatology, the First Affiliated Hospi- tal of Kunming Medical University from 2008 to 2015 retrospectively. Resulta Among the 39 cases of cutaneous malignant melanoma, male patients is 15 cases （38.5 % ） , females is 24 cases （61.5 % ） ; their age is between 17 and 84 years, the mean age is 58.5±12.5, there are 2 cases whose age were under the 20 （5.2%） , 3 cases between the ages of 20 and 40 （7.7%） , 13 cases are in 41-60 years of age （ 33.3 % ） , and 21 cases are over the age of 61 （ 53. 8% ） ; involvement parts of limb is 31 cases （79.5%） , 6 cases of patients with lesions on the face （ 15.3% ） , only 1 case is in the left knee and back sev- erally （2.6%）, 17 cases with ulcer（43.6% ）, no ulcer in 22 cases （56.4%）. All patients, the clinical diagnosis accorded with pathology accounts for 31 patients （79.5%） ; immunohistochemical staining of S 100 （＋） accounts for 27 （69.23%）, HMB 45 （＋） is 28 （71.79%）, Melanin-A is 27 cases （ 69.23 % ） , Ki-67 （ ＋ ） is 24 （ 61.54% ）. Conclusion Clinical characteristics of CMM ： the skin melanoma occured mainly in the elderly ; the lesions are more to be acral sites. Spotted invasion depth is II level and below; plaques, nodules and ulcers invasion depth is III and above.