西安、重庆两所医院20年皮肤恶性黑素瘤回顾

Review of Cutaneous Malignant Melanoma from Two General Hospitals in Western China, 1981-2000

目的了解西安及重庆两所医院20年来皮肤恶性黑素瘤的临床、病理特点及发病趋势;比较两地差异;探讨皮肤恶性黑素瘤发病诱因。方法收集1981年1月1日至2000年12月31日新确诊的305例患者的临床资料,并对185例具备完整病理资料者进行分析。结果63.3%的皮肤恶性黑素瘤发生于肢端;依据临床病史,15.8%原发部位曾有先天性小痣;20世纪80、90年代皮肤恶性黑素瘤分别占同期病理活检数比例为0.053%、0.094%,该比例的年增长率为3.9%;20年来面、颈部皮肤恶性黑素瘤比例逐渐增加,足部减少。结论肢端是皮肤恶性黑素瘤最常见的发病部位,20年来上述两所医院皮肤恶性黑素瘤占活检数的比例有增加的趋势。

Objective To review the clinical-pathological features, the tendency of incidence over 20 years, the predisposing factors, and the differences between the cases of cutaneous malignant melanoma from two hospitals. Methods A collection of 305 cases diagnosed as cutaneous malignant melanoma, among which 185 cases had complete clinical-pathological data, during 1981-2000 was analyzed. Results Acral malignant melanoma accounted for 63.3%, and the cases associated with congenital small nevi at the primary site accounted for 15.8% of 305 patients. During the period 1981-1990 and 1991-2000, cutaneous malignant melanoma constituted 0.053% and 0.094%, respectively, of all diagnoses with pathological sections, with an growth rate of 3.9% yearly. There was a tendency of the increased lesions located on face and neck, and decreased lesions on acra, over 20 years. Conclusion A rise of diagnosis of cutaneous malignant melanoma has been noticed from two hospitals over 20 years. Acra, especially planta, is the predominant anatomical site of cutaneous malignant melanoma.