CAJ | 학술논문

目的总结甲下黑色素瘤的临床特点和治疗结果.方法回顾性分析1994年1月至2010年7月由北京积水潭医院收治,并经病理检查证实为甲下黑色素瘤的31例患者的临床资料,其中21例行病变指(趾)超关节截指(趾)术;4例行序列截指(趾)术;6例行局部/扩大切除术.其中5例淋巴转移患者同时行局部淋巴结清扫,并辅以全身化学治疗和免疫治疗.结果 31例中18例获得随访,随访年限3～16年.4例行序列截指(趾)术后随访均未复发;8例行超关节截指(趾)中2例复发;6例行局部病灶切除或扩大切除术中5例复发.侵袭性甲下黑色素瘤患者1年生存率为88.9%(8/9),3年生存率为66.7%(6/9),5年生存率为33.3%(3/9).结论甲下黑色素瘤是一种恶性程度很高的肿瘤,具有非特异性的临床表现,治疗应以手术为主,辅以化疗、免疫等综合治疗.
목적 총결갑하흑색소류적림상특점화치료결과.방법 회고성분석1994년1월지2010년7월유북경적수담의원수치,병경병리검사증실위갑하흑색소류적31례환자적림상자료,기중21례행병변지(지)초관절절지(지)술;4례행서렬절지(지)술;6례행국부/확대절제술.기중5례림파전이환자동시행국부림파결청소,병보이전신화학치료화면역치료.결과 31례중18례획득수방,수방년한3～16년.4례행서렬절지(지)술후수방균미복발;8례행초관절절지(지)중2례복발;6례행국부병조절제혹확대절제술중5례복발.침습성갑하흑색소류환자1년생존솔위88.9%(8/9),3년생존솔위66.7%(6/9),5년생존솔위33.3%(3/9).결론 갑하흑색소류시일충악성정도흔고적종류,구유비특이성적림상표현,치료응이수술위주,보이화료、면역등종합치료.
Objective To review and summarize the clinical features and treatment outcomes of subungual melanoma. Methods The clinical data of 31 cases of subungual melanoma with pathological confirmation that were admitted and treated from January 1994 to July 2010 in Jishuitan Hospital were retrospectively analyzed. Amputation of the involved fingers (toes) at the level proximal to the adjacent joint was done in 21 patients. Complete amputation of the digits (toes) was carried out in 4 cases. Other 6 cases had wide/extended local excision. There were 5 patients who had regional lymph node metastasis that underwent lymph node excision along with chemotherapy and immunotherapy. Results Eighteen patients had long-term follow-up ranging from 3 to 16 years. No recurrence was found in the 4 cases that underwent complete amputation of the involved digits (toes). Melanoma recurred in 2 of the 8 cases treated with amputation at the level proximal to the adjacent joint. Five out of the 6 cases undergoing wide/extended local excision recurred. The 1-year, 3-year and 5-year survival rates of invasive melanoma were 88.9 % (8/9), 66.7 % (6/9) and 33.3 % (3/9),respectively. Conclusion Subungual melanoma is a highly malignant tumor with non-specific clinical manifestations. Surgical resection is the major treatment, which should be supplemented with chemotherapy and immunotherapy.