黑色素瘤肝转移超声及临床病理特征分析

Ultrasonographic features and clinical pathological of liver metastasis in patients with melanoma

目的探讨黑色素瘤肝转移的超声及临床病理特征。方法选取2013—2019年于天津医科大学肿瘤医院诊治的13例黑色素瘤肝转移患者, 回顾性分析其超声及临床病理特征。结果 13例患者中, 肝转移病灶多发11例, 病灶长径为(5.89±2.73)cm。肝转移病灶为混合回声5例(黑色素高含量3例), 高回声4例(黑色素低含量3例), 低回声3例(均为黑色素高含量), 等回声1例(黑色素高含量)。肝转移病灶边界尚清11例, 边界不清2例, 病灶出现囊性区3例。肝转移病灶不规则(分叶状、小分叶状)6例, 尚规则(圆形、卵圆形)7例。病灶周边有声晕9例, 声晕为光滑、不均匀5例。免疫组化结果显示, S-100、HMB45及Melan-A均为阳性11例;1例患者未行HMB45检测, S-100及Melan-A为阳性;1例患者未行Melan-A检测, S-100及HMB45为阳性。结论黑色素瘤肝转移病灶多数为混合回声或高回声, 多数为边界清晰的结节型且伴有声晕, 少数病灶可见囊性区。

Objective To investigate the ultrasonographic features and clinical pathological of liver metastasis in patients with melanoma.Methods Thirteen patients with liver metastasis from melanoma treated in Tianjin Medical University Cancer Institute and Hospital from 2013 to 2019 were selected,and their ultrasonographic and clinicopathological characteristics were analyzed retrospectively.Results Eleven of the 13 patients had multiple liver lesions.The maximum diameter of the lesions was(5.89±2.73)cm.Five cases of lesions were mixed echo(3 cases with high melanin content),4 cases of lesions were hyperechoic(3 cases with low melanin content),3 cases of lesions were hypoechoic(all with high melanin content),1 case of lesions were equal echo(with high melanin content).The lesions in 11 patients had clear boundaries,while other 2 patients lacked the clear borders.Cystic areas were present in the lesions of 3 patients.Six cases had irregular lesions(lobulated),and 7 cases had regular lesions(round,oval).There were acoustic halos around the lesion in 9 cases and smooth and uneven acoustic halos in 5 cases.The results of immunohistochemistry showed that 11 cases were positive for S-100,HMB45 and Melan-A.One patient was not tested for HMB45,while S-100 and Melan-A were positive.One patient did not undergo Melan-A test,while S-100 and HMB45 were positive.Conclusion Most of the liver metastases of melanoma are mixed echo or hyperechoic,most of them are nodular with clear boundaries combined with vocal halo,and a few of the lesions have cystic areas.