中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2014年
11期
916-919
,共4页
鼻肿瘤%黑色素瘤%鼻黏膜%综合治疗%预后
鼻腫瘤%黑色素瘤%鼻黏膜%綜閤治療%預後
비종류%흑색소류%비점막%종합치료%예후
Nose neoplasm%Melanoma%Nasal mucosa%Combined modality therapy%Prognosis
目的 总结鼻黏膜恶性黑色素瘤患者的临床特征和治疗方法,探讨影响其预后的因素.方法 回顾性分析天津市环湖医院耳鼻咽喉头颈外科1999年10月至2013年6月收治的29例鼻黏膜恶性黑色素瘤患者的临床资料,其中男18例,女11例,中位发病年龄61.5岁.根据美国癌症联合委员会肿瘤分期系统(AJCC)对患者进行分期,8例为T1,10例为T2,6例为T3,5例为T4.29例患者中22例次接受手术治疗,28例次接受放射治疗,17例次接受化疗.采用Kaplan-Meier法分析性别、年龄、发病部位、临床分期、治疗方法、组织病理学特征等因素对预后的影响.结果 本组患者总的3年生存率为48.3％,5年生存率为27.6％.其中发病部位、T分期、是否行手术治疗和肿瘤是否有黑色素沉着4个因素影响患者的5年生存率(P值分别为0.008、0.012、0.021、0.027).而性别、年龄、化疗等其他因素对5年生存率无影响.结论 AJCC肿瘤分期系统可以有效地预测患者的预后.发病部位在鼻中隔的患者的预后要好于其他患者.以手术治疗为主的综合治疗是首选的治疗方法.组织学特征例如肿瘤黑色素沉着影响患者的预后.
目的 總結鼻黏膜噁性黑色素瘤患者的臨床特徵和治療方法,探討影響其預後的因素.方法 迴顧性分析天津市環湖醫院耳鼻嚥喉頭頸外科1999年10月至2013年6月收治的29例鼻黏膜噁性黑色素瘤患者的臨床資料,其中男18例,女11例,中位髮病年齡61.5歲.根據美國癌癥聯閤委員會腫瘤分期繫統(AJCC)對患者進行分期,8例為T1,10例為T2,6例為T3,5例為T4.29例患者中22例次接受手術治療,28例次接受放射治療,17例次接受化療.採用Kaplan-Meier法分析性彆、年齡、髮病部位、臨床分期、治療方法、組織病理學特徵等因素對預後的影響.結果 本組患者總的3年生存率為48.3％,5年生存率為27.6％.其中髮病部位、T分期、是否行手術治療和腫瘤是否有黑色素沉著4箇因素影響患者的5年生存率(P值分彆為0.008、0.012、0.021、0.027).而性彆、年齡、化療等其他因素對5年生存率無影響.結論 AJCC腫瘤分期繫統可以有效地預測患者的預後.髮病部位在鼻中隔的患者的預後要好于其他患者.以手術治療為主的綜閤治療是首選的治療方法.組織學特徵例如腫瘤黑色素沉著影響患者的預後.
목적 총결비점막악성흑색소류환자적림상특정화치료방법,탐토영향기예후적인소.방법 회고성분석천진시배호의원이비인후두경외과1999년10월지2013년6월수치적29례비점막악성흑색소류환자적림상자료,기중남18례,녀11례,중위발병년령61.5세.근거미국암증연합위원회종류분기계통(AJCC)대환자진행분기,8례위T1,10례위T2,6례위T3,5례위T4.29례환자중22례차접수수술치료,28례차접수방사치료,17례차접수화료.채용Kaplan-Meier법분석성별、년령、발병부위、림상분기、치료방법、조직병이학특정등인소대예후적영향.결과 본조환자총적3년생존솔위48.3％,5년생존솔위27.6％.기중발병부위、T분기、시부행수술치료화종류시부유흑색소침착4개인소영향환자적5년생존솔(P치분별위0.008、0.012、0.021、0.027).이성별、년령、화료등기타인소대5년생존솔무영향.결론 AJCC종류분기계통가이유효지예측환자적예후.발병부위재비중격적환자적예후요호우기타환자.이수술치료위주적종합치료시수선적치료방법.조직학특정례여종류흑색소침착영향환자적예후.
Objective To summarize the clinical characteristics and treatment of patients with malignant nasal mucosa melanoma,and explore the factors influencing the prognosis of malignant nasal mucosa melanoma.Methods To retrospectively analyze the clinical data of 29 patients with malignant nasal mucosa melanoma in Tianjin Huanhu hospital,department of otorhinolaryngology head and neck surgery between October,1999 and June,2013.Eighteen of them were male,other eleven were female,the median age was 61.5 years.The patients were staged according to the American Joint Committee on Cancer(AJCC) staging system,eight cases were in T1,ten cases were in T2,six cases were in T3,five cases were in T4.Among the 29 cases,twenty-two patients received surgical treatment,twenty-eight patients accepted radiotherapy,seventeen patients had the chemotherapy.The Kaplan-Meier method was used to analyze the prognosis impacts of gender,age,disease location,clinical staging,treatment,and histopathological features and so on.Results In this series,the overall 3 year survival rate was 48.3％ and 5 year survival rate was 27.6％.There were 4 factors effecting the 5 year survival rate:the location of tumor,T stage,surgical treatment and black pigmentation (P value was 0.008,0.012,0.021 and 0.027).But,gender,age,chemotherapy and other factors had no effect on overall survival rate.Conclusions AJCC staging system can effectively predict the prognosis of patients.The prognosis of patients with pathogenic site in nasal septum is better than the others.The surgical treatment is the preferred method of treatment.Histological features such as tumor melanin pigmentation affect the prognosis of the patients.
