皮肤恶性黑色素瘤的临床特征及预后因素分析
|
摘要
目的探讨皮肤恶性黑色素瘤(CMM)的临床特征及影响预后的因素。方法回顾性分析80例CMM患者的临床资料,以患者的性别、年龄、肿瘤部位、肿瘤大小、肿瘤厚度、肿瘤有无溃疡、肿瘤分期、淋巴结转移情况、乳酸脱氢酶(lactate dehydrogenase,LDH)水平、BRAF突变、治疗方法等因素进行分析,研究其对预后生存的影响。结果单因素分析显示:肿瘤部位、肿瘤大小、肿瘤厚度、肿瘤有无溃疡、肿瘤分期、淋巴结转移情况、LDH水平、BRAF基因状态、术后是否行辅助治疗9个因素是影响CMM患者生存预后因素(P <0. 05)。多因素分析显示:肿瘤厚度、肿瘤有无溃疡、肿瘤分期、BRAF基因状态是影响CMM患者生存时间的独立预后危险因素(P <0. 05)。结论肿瘤浸润深、肿瘤表面有溃疡、临床分期较晚、BRAF V600E突变的患者预后较差。
Objective To analyze the clinical characteristics and prognostic factors of cutaneous malignant melanoma( CMM). Methods Clinical data of 80 CMM patients were retrospectively analyzed. The factors including patients' gender,age,tumor site,tumor size,tumor thickness,tumor ulcer,tumor stage,lymph node metastasis,lactate dehydrogenase( LDH),BRAF mutation and treatment were analyzed to study its influence on prognosis and survival. Results Univariate analysis showed that 9 factors,including tumor site,tumor size,tumor thickness,tumor ulcer,tumor stage,lymph node metastasis,LDH level,BRAF gene status,and postoperative adjuvant therapy,were the prognostic factors of CMM patients( P < 0. 05). Multivariate analysis showed that tumor thickness,tumor ulcer,tumor stage and BRAF gene status were independent prognostic risk factors influencing survival time of CMM patients. Conclusion Patients with deep tumor infiltration,ulcer on tumor surface,late clinical stage and BRAF V600 E mutation had a poor prognosis.
Objective To analyze the clinical characteristics and prognostic factors of cutaneous malignant melanoma( CMM). Methods Clinical data of 80 CMM patients were retrospectively analyzed. The factors including patients' gender,age,tumor site,tumor size,tumor thickness,tumor ulcer,tumor stage,lymph node metastasis,lactate dehydrogenase( LDH),BRAF mutation and treatment were analyzed to study its influence on prognosis and survival. Results Univariate analysis showed that 9 factors,including tumor site,tumor size,tumor thickness,tumor ulcer,tumor stage,lymph node metastasis,LDH level,BRAF gene status,and postoperative adjuvant therapy,were the prognostic factors of CMM patients( P < 0. 05). Multivariate analysis showed that tumor thickness,tumor ulcer,tumor stage and BRAF gene status were independent prognostic risk factors influencing survival time of CMM patients. Conclusion Patients with deep tumor infiltration,ulcer on tumor surface,late clinical stage and BRAF V600 E mutation had a poor prognosis.
引文
[1]李治,张林梦,斯越秀,等.恶性黑色素瘤的研究进展[J].药物生物技术,2018,25(1):70-74.
[2]刘清,武峻申,戴志兵,等.皮肤恶性黑色素瘤预后的影响因素分析[J].中国现代医学杂志,2018,28(29):69-73.
[3]Tas F,Karabulut S,Yegen G,et al.Tongue metastasis of melanoma[J].J Cancer Res Ther,2015,11(3):660.
[4]SCO黑色素瘤专家委员会.中国黑色素瘤诊治指南(2011版)[J].临床肿瘤学杂志,2012,17(2):159-171.
[5]Niebling,Maarten G,Haydu,et al.Reproducibility of AJCCstaging parameters in primary cutaneous;melanoma:an analysis of 4,924 cases[J].Annals of Surgical Oncology,2013,20(12):3969-3975.
[6]王华斌.皮肤恶性黑色素瘤手术联合免疫疗法的临床研究[J].实用癌症杂志,2016,31(9):1553-1555.
[7]吴达军,许峰.晚期恶性黑色素瘤的新药治疗进展[J].华西医学,2016,31(12):2079-2083.
[8]VOSS B,WILOP S,JONAS S,et al.Tumor volume as a prognostic factor in resectable malignant melanoma[J].Dermatology,2014,228(1):66-70.
[9]Jemal A,Siegel R,Ward E,et al.Cancer statistics,2008[J].CA Cancer J Clin,2008,58(2):71-96.
[10]Ingkaninanda P,Visessiri Y,Rutnin S.Clinicopathological features and prognostic factors of malignant melanoma:a retrospective analysis of thai patients in ramathibodi hospital.[J].J Med Assoc Thai,2015,98(8):820-827.
[11]CORDEIRO E,GERVAIS MK,SHAH PS,et al.Sentinel lymph node biopsy in thin cutaneous melanoma:a systematic review and meta-analysis[J].Ann Surg Oncol,2016,23(13):4178-4188.
[12]李婧婧,曹啸,张晓实.BRAF抑制剂治疗晚期黑色素瘤的研究进展[J].临床肿瘤学杂志,2018,23(1):73-78.
[13]李鹏杰.皮肤恶性黑色素瘤的临床、病理特点及预后分析[D].郑州大学,2017.
[14]张璇.原发性皮肤恶性黑色素瘤的特征及预后影响因素分析[J].解放军预防医学杂志,2017,35(7):790-792.
[15]张庆莲,张青云.乳酸脱氢酶同工酶在肿瘤诊断中的临床意义[J].中华临床实验室管理电子杂志,2015,3(2):82-86.
[2]刘清,武峻申,戴志兵,等.皮肤恶性黑色素瘤预后的影响因素分析[J].中国现代医学杂志,2018,28(29):69-73.
[3]Tas F,Karabulut S,Yegen G,et al.Tongue metastasis of melanoma[J].J Cancer Res Ther,2015,11(3):660.
[4]SCO黑色素瘤专家委员会.中国黑色素瘤诊治指南(2011版)[J].临床肿瘤学杂志,2012,17(2):159-171.
[5]Niebling,Maarten G,Haydu,et al.Reproducibility of AJCCstaging parameters in primary cutaneous;melanoma:an analysis of 4,924 cases[J].Annals of Surgical Oncology,2013,20(12):3969-3975.
[6]王华斌.皮肤恶性黑色素瘤手术联合免疫疗法的临床研究[J].实用癌症杂志,2016,31(9):1553-1555.
[7]吴达军,许峰.晚期恶性黑色素瘤的新药治疗进展[J].华西医学,2016,31(12):2079-2083.
[8]VOSS B,WILOP S,JONAS S,et al.Tumor volume as a prognostic factor in resectable malignant melanoma[J].Dermatology,2014,228(1):66-70.
[9]Jemal A,Siegel R,Ward E,et al.Cancer statistics,2008[J].CA Cancer J Clin,2008,58(2):71-96.
[10]Ingkaninanda P,Visessiri Y,Rutnin S.Clinicopathological features and prognostic factors of malignant melanoma:a retrospective analysis of thai patients in ramathibodi hospital.[J].J Med Assoc Thai,2015,98(8):820-827.
[11]CORDEIRO E,GERVAIS MK,SHAH PS,et al.Sentinel lymph node biopsy in thin cutaneous melanoma:a systematic review and meta-analysis[J].Ann Surg Oncol,2016,23(13):4178-4188.
[12]李婧婧,曹啸,张晓实.BRAF抑制剂治疗晚期黑色素瘤的研究进展[J].临床肿瘤学杂志,2018,23(1):73-78.
[13]李鹏杰.皮肤恶性黑色素瘤的临床、病理特点及预后分析[D].郑州大学,2017.
[14]张璇.原发性皮肤恶性黑色素瘤的特征及预后影响因素分析[J].解放军预防医学杂志,2017,35(7):790-792.
[15]张庆莲,张青云.乳酸脱氢酶同工酶在肿瘤诊断中的临床意义[J].中华临床实验室管理电子杂志,2015,3(2):82-86.