手指恶性黑色素瘤的临床特征与疗效分析

目的 探讨手指恶性黑色素瘤的临床特征及治疗效果.方法 回顾性分析1995年2月-2007年10月收治并经病理检查证实的22例手指恶性黑色素瘤的临床资料,其中拇指12例,示、中指各3例,环、小指各2例.手指黑斑及疼痛为共同的首发症状,15例有甲下病变,12例有外伤史,2例X线片显示指骨有溶骨性改变.主要采用手术、全身化疗及免疫治疗.所有患者均采用截指术,其中13例行同侧腋窝淋巴结清扫术.结果 22例患者获得随访,其中3例2年后失访.随访时间为1～10年,平均4.5年.1年生存率为86.4%(19/22),3年生存率为63.2%(12/19),5年生存率为31.6%(6/19).结论 手指恶性黑色素瘤临床少见,治疗应以手术、化疗、免疫治疗等综合方法为主.其预后与肿瘤大小、浸润深度及临床分期有关.

Clinical features and treatment outcome of malignant melanoma of the fingers

Objective To explore the clinical features as well as the treatment outcome of malignant melanoma of fingers. Methods The clinical data of 22 eases of malignant melanoma of the fingers with histology confirmation that were admitted and treated from February 1995 to October 2007 in our hospital were retrospectively analyzed.The primary site of tumors was thumb in 12 cases,index finger in 3 cases,middle finger in 3 cases,ring finger in 2 cases,and little finger in 2 cases.The most often initial presentang symptom was pain and black patches in the fingers.Fifteen cases had subungual diseases,12 cases had history of trauma, and 2 cases had osteolytic lesion of the phalanx as shown in X-ray.The main treatments were surgery, chemotherapy and immunotherapy.All patients undertook finger amputation,while 13 cases had axillary lymph node reaction at the same time.Results Twenty-two patieats were followed,however 3 of them were lost to follow up 2 years later.The follow up period maged from 1 to 10 years,the average being 4.5 years.The 1-year,3-years and 5-years survival rates were 86.4%(19/22),63.2%(12/19) and 31.6%(6/19), respectively. Conclusion Malignant melanoma of the fingers is a rare malignant tumor.Combination therapy including surgery.chemotherapy and immunotherapy is the main treatment.The prognostic factors were the size and infiltrate depth of the tumor, and the clinical stages.