肢端恶性黑素瘤100例临床和病理分析

Acral Malignant Melanoma: Clinical-Pathological Features of 100 Cases

目的 探讨肢端恶性黑素瘤的临床、病理特点和外伤在发病中的意义以及现行分型方法的有效性。方法 选取最近诊断的具有完整临床、病理资料的100例肢端恶性黑素瘤,对其临床、病理数据进行统计分析。结果 原发于手28例,其中拇指甲下14例;足72例,足掌跖29例,足跟18例,拇趾甲下12例。31例原发部位有外伤史。40例肢端恶性黑素瘤难以用目前的分型方法分型,依据现行病理分型方法,肢端雀斑样痣性、结节性、浅表扩散性黑素瘤在肿瘤浸润深度、临床分期等方面差异无显著性。结论 足部是肢端恶性黑素瘤的好发部位,外伤是发病的重要诱因,现行分型方法的临床意义尚需进一步研究。

Objective To study the role of trauma in the pathogenesis of acral malignant melanoma (AMM) and evaluate current AMM classification system through reviewing clinical-pathological features of AMM. Methods One hundred newly diagnosed AMM cases with complete clinical and pathological data were analyzed. Results The primary lesions of 72 cases were located on feet (29 cases on plantar, 18 cases heel and 12 cases big toe); and 28 cases on hands (14 cases under thumb nails). There was a trauma history at the primary melanoma site in 31 cases. Forty cases of acral malignant melanoma couldn't be clas-sified with current classification system. There was no significant difference according to current classifica-tions methods, in invasive level, clinical staging and so on. Conclusion The predominant location of acral malignant melanoma is foot. Trauma may be an important inductive factor for acral malignant melanoma. The current classification system needs improve through further investigation.