黏膜黑色素瘤患者的临床特征及预后影响因素分析

Clinical characteristics and factors influencing the prognosis of patients with mucosal melanoma

目的探讨黏膜黑色素瘤的临床特征及预后影响因素。方法回顾性分析2012年3月至2022年3月福建省肿瘤医院49例黏膜黑色素瘤患者的临床资料, 观察其临床特征及预后影响因素。采用Kaplan-Meier法进行生存分析, 应用Cox比例风险模型进行预后因素分析。结果 49例黏膜黑色素瘤患者中女性占61.2%(30/49), 中位年龄56岁(42~79岁)。原发肿瘤部位以头颈部最多(42.9%, 21/49), 生殖系统次之(32.7%, 16/49)。初诊时无远处转移的患者占81.6%(40/49), 初诊时外周血乳酸脱氢酶水平正常的占79.6%(39/49)。中位总生存时间为39.5个月(95%CI 23.1~55.9个月)。初诊时无远处转移患者的中位总生存时间为46.5个月(95%CI 31.6~61.4个月), 显著长于合并远处转移患者的19.2个月(95%CI 0~42.2个月)(P=0.025)。不同性别、初诊年龄、原发肿瘤部位、初诊时外周血乳酸脱氢酶水平患者的中位总生存时间比较差异均无统计学意义(均P>0.05)。初诊时合并远处转移是黏膜黑色素瘤患者预后的独立危险因素(HR=0.379, 95%CI 0.157~0.918, P=0.032)。结论黏膜黑色素瘤患者以女性多见, 原发肿瘤以头颈部多见。初诊时无远处转移、外周血乳酸脱氢酶正常居多。初诊时是否合并远处转移是黏膜黑色素瘤患者预后的独立影响因素。

Objective To investigate clinical characteristics and factors influencing the prognosis of patients with mucosal melanoma.Methods The clinical data of 49 patients with mucosal melanoma in Fujian Cancer Hospital from March 2012 to March 2022 were retrospectively analyzed,and their clinical characteristics and prognostic influencing factors were observed.Kaplan‐Meier method was used for survival analysis and Cox proportional risk model was used to analyze the prognostic influencing factors.Results Female accounted for 61.2%,(30/49)of all 49 patients with mucosal melanoma and the median age was 56 years(42-79 years).The most frequent primary tumor sites occurred in head and neck(42.9%,21/49),followed by the reproductive system(32.7%,16/49).At the time of initial diagnosis,81.6%(40/49)of patients had no distant metastasis and 79.6%(39/49)of patients had normal levels of peripheral blood lactate dehydrogenase.The median overall survival time of 49 patients with mucosal melanoma was 39.5 months(95%CI 23.1-55.9 months).The median overall survival time of patients without distant metastasis at the time of initial diagnosis was significantly longer than that of patients with distant metastasis[46.5 months(95%CI 31.6-61.4 months)vs.19.2 months(95%CI 0-42.2 months,P=0.025)].There were no statistically significant differences in median overall survival time of patients with different gender,age at the time of initial diagnosis,primary tumor site,and the level of lactate dehydrogenase in peripheral blood at the time of initial diagnosis(all P>0.05).The presence of distant metastasis at the time of initial diagnosis was an independent risk factor for the prognosis of patients with mucosal melanoma(HR=0.379,95%CI 0.157-0.918,P=0.032).Conclusions Mucosal melanoma is more common in female.The most frequent primary tumor sites occur in head and neck.At the time of initial diagnosis,most patients have non‐distant metastasis and the normal level of peripheral blood lactate dehydrogenase.At the time of initial diagnosis,whether there is distant metastasis is an independent influencing factor for the prognosis of patients with mucosal melanoma.