华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

口腔粘膜原发恶性黑色素瘤的临床病理学研究

陈艳,何志秀,吴兰雁,刘来奎   

  1. 100083 北京大学口腔医院病理科(陈 艳),四川大学华西口腔医院病理科(何志秀,吴兰雁,刘来奎)
  • 收稿日期:2003-02-25 修回日期:2003-02-25 出版日期:2003-02-20 发布日期:2003-02-20

A Clinical and Pathological Study on Primary Oral Mucosal Malignant Melanoma

CHEN Yan*,HE Zhixiu,WULanyan,et al.   

  1. *Department ofPathology,West China College ofStomatology,Sichuan Universi- ty,Chengdu610041,China
  • Received:2003-02-25 Revised:2003-02-25 Online:2003-02-20 Published:2003-02-20

摘要:

目的 研究口腔粘膜原发恶性黑色素瘤的临床病理特点及其与预后的关系。方法 采用回顾性分析的方法对73例口腔粘膜原发恶性黑色素瘤进行了临床病理学研究并对有随访资料的患者进行Kaplan-meier生存曲线及Log rank检验的统计学分析。结果 口腔粘膜原发恶性黑色素瘤多发于40~60岁的男性,腭部和牙龈多见。临床分期以I期最多;病理分型中结节型多见,其次是雀斑样型和表浅扩散型;按细胞形态分型以混合细胞型最为多见,其次是上皮样细胞型和梭形细胞型。有随访资料的43例患者3年生存率为19·86%,5年生存率为11·91%;淋巴结转移、浸润深度、临床分期、病理分型和治疗方法与预后有关(P<0·05)。黑斑与病理分型有关(P<0·05),黑斑多见于雀斑样型口腔粘膜原发恶性黑色素瘤,且预后较好。结论 口腔粘膜恶性黑色素瘤是一种预后差的恶性肿瘤;有无黑斑和淋巴结转移、浸润深度、临床分期、病理分型、治疗方法等与预后有关。

关键词: 黑色素瘤, 口腔粘膜, 病理学

Abstract:

Objective The aim of this study was to investigate the association between clinical and pathological characteris- tics of primary oral mucosal malignant melanoma and the prognosis of this disease.Methods Clinical and pathological characters of 73 cases primary oral mucosal malignant melanoma were investigated. The association between risk factors, such as black macule, lymph node metastases, invasive depth, clinic stages, pathologic types, and prognosis was analyzed using Kaplan-Meier survival analysis and Log rank test.Results The age of the patients ranged from 24 to 80 years (Median age, 50). Among the patients, 43 were males and 30 were females. The most common locations of the tumorwere palate and gingiva. The clinic stages of these patients were as the following: StageⅠ(46/73), StageⅡ(24/73), StageⅢ(3/73). The most common pathological type was nodular (44/73), followed by lentiginose malignant melanoma (15/73) and superficial spreading (1/73). According to the configuration of tumor cells, the most common typewas the mixed cell type (37/73), followed bythe epitheloid cell type (27/73) and the spindle cell type (9/73). Among the 73 patients, 43 were followed up, the 3-year and 5-year survival rates were 19.86% and 11.91% respec- tively. Black macule, lymph node metastases, invasive depth, clinic stages, pathologic types and therapeutic methods were signifi- cantly associated with the prognosis (P<0.05).Conclusion The prognosis of the primary oral mucosal malignant melanoma is as- sociated with black macule, lymph node metastases, invasive depth, clinic stages, pathologic types, and therapeutic methods.

Key words: oral mucosal malignant melanoma, oral mucosa, pathology