头颈部粘膜恶性黑色素瘤临床回顾分析

The Retrospective Analysis of 62 Subjects with Mucosal Melanomas of the Head and Neck

目的 评估对头颈部粘膜恶性黑色素瘤 (MMHN)治疗方法的效果。方法 对 195 5～ 1997年间华西医科大学口腔医院收治的 6 2例资料齐全的MMHN患者进行统计分析 ,一般资料和治疗手段作为统计对象。结果 MMHN患者Ⅰ期 32例 (5 1.6 1% ) ,Ⅱ期 2 3例 (37.10 % ) ,Ⅲ期 7例 (11.2 9% ) ,所有患者都经过手术治疗 ,部分在术后辅以化疗、放疗和免疫治疗。共有 18例 (2 9.0 3% )出现局部复发 ,14例 (2 2 .5 8% )出现转移 ,其中 4例 (6 .4 5 % )为局部复发伴转移。结论 对MMHN术前切忌切取活检 ,现有的术后辅助治疗手段对MMHN意义不大 ;对颈部的淋巴转移应保持高度警惕 。

Objective To assess the outcome and identify clinical treatment of patients with mucosal melanomas of the head and neck (MMHN). Methods The clinical data of 62 subjects with MMHN treated at the West China Stomotology Hospital between 1955 and 1997 were retrospectively reviewed. The general clinical information and treatment data were analyzed. Results 32 subjects(51.61%) were staged as stage Ⅰ, 23(37.10%) as stage Ⅱ, and 7(11.29%) as stage Ⅲ. All the subjects had the surgery. A part of them got the adjuvant therapy. The rate of local recurrence was 29.03%, and metastasis rate was 22.58%. Conclusion It's forbidden to cut part of tumor for biopsy and the adjuvant therapy had little effect. For the cases of stage Ⅰ, more attention should be paid to the metastases and the neck dissection is necessary in the presence of high risk factors of metastases.