肛管直肠恶性黑色素瘤36例诊治及预后分析

发布时间：2018-03-03 06:12

本文选题：肛管直肠肿物　切入点：恶性黑色素瘤　出处：《中国肿瘤临床》2017年14期 　论文类型：期刊论文

【摘要】：目的:分析肛管直肠恶性黑色素瘤(anorectal malignant melanoma,ARMM)患者的临床病理特征及诊治过程,探讨其预后因素及误诊原因。方法:回顾性分析2000年1月至2016年11月南方医科大学南方医院、南方医科大学珠江医院、广东省中医院收治的36例ARMM患者的临床资料。结果:ARMM临床表现无特异性,误诊率高达52.8%,患者1年和3年生存率分别为75%和35%,中位生存时间为24.51个月。生存率与肿瘤大小、浸润深度、临床分期、淋巴结转移相关,与患者发病年龄、性别无关。单纯手术治疗、采取手术为主的联合治疗、未治疗患者的中位生存时间分别为39.21、26.00、15.00个月,但受病例数所限,其差异无统计学意义;比较经腹会阴联合切除术和广泛性局部扩大切除术患者的生存率差异无统计学意义。结论:ARMM预后差,肿瘤大小、浸润深度、临床分期和淋巴结转移是影响预后的因素,手术治疗可延长患者的生存期。因临床易误诊,为尽量避免误诊发生,应做到早诊断、早治疗,对延长患者生存期有重要意义。
[Abstract]:Objective: to analyze the clinicopathological features, diagnosis and treatment of anorectal malignant anoma (ARMMM) patients, and to explore the prognostic factors and misdiagnosis reasons. Methods: from January 2000 to November 2016, the Southern Hospital of Southern Medical University was retrospectively analyzed. Clinical data of 36 patients with ARMM treated in Zhujiang Hospital, Southern Medical University, Guangdong Provincial Hospital of traditional Chinese Medicine. The misdiagnosis rate was as high as 52.8%. The 1-year and 3-year survival rates were 75% and 35, respectively, and the median survival time was 24.51 months. The survival rate was correlated with tumor size, depth of invasion, clinical stage, lymph node metastasis and age. The median survival time of untreated patients was 39.21% 26.00 months and 15.00 months respectively, but the difference was not statistically significant due to the number of cases. There was no significant difference in the survival rate between patients undergoing transabdominal perineal resection and extensive local excision. Conclusion the prognosis of the patients is poor, tumor size, depth of invasion, clinical stage and lymph node metastasis are the factors affecting the prognosis. Surgical treatment can prolong the survival time of patients. In order to avoid misdiagnosis as far as possible, early diagnosis and treatment should be done, which is of great significance to prolong the survival time of patients.
【作者单位】：南方医科大学南方医院消化内科广东省胃肠疾病重点实验室;南方医科大学珠江医院重症医学科;广东省中医院大学城医院放疗科;
【基金】：国家自然科学基金(编号:81470790) 广东省自然基金(编号:2015A030313295)资助~~
【分类号】：R735.3

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