原发性宫颈恶性黑色素瘤13例临床分析

目的：提高对原发性宫颈恶性黑色素瘤的认识及治疗水平。方法：回顾性分析2013年1月—2019年12月郑州大学附属肿瘤医院收治的13例经病理确诊为原发性宫颈恶性黑色素瘤患者的病例资料，分析其临床特征、治疗及预后情况。结果：13例患者年龄30～64岁，平均（51.1±10.8）岁，国际妇产科联盟（International Federation of Gynecology and Obstetrics,FIGO）2018版分期Ⅰ期4例，Ⅱ期3例，Ⅲ期1例，Ⅳ期5例。6例ⅠA～ⅡA期患者行手术治疗，其中2例仅观察，3例术后接受化疗，1例接受化疗+免疫治疗。2例ⅡB～Ⅲ期患者及2例Ⅳ期患者接受放疗+化疗。其余3例Ⅳ期患者接受化疗、局部放疗、免疫治疗或靶向治疗的综合治疗。中位随访时间12个月（7～84个月），9例死亡，3例远处转移，中位总生存期38个月。结论：原发性宫颈恶性黑色素瘤是一种较为罕见但恶性程度极高的肿瘤，预后差，易远处转移。手术切除是早期患者的主要治疗方式，不能进行根治性手术的患者可选择免疫及靶向治疗的综合治疗方法。

Clinical Analysis of 13 Cases of Primary Cervical Malignant Melanoma

Objective: To investigate the clinical characteristics, treatment and prognosis of primary cervical malignant melanoma. Methods: The clinical data and follow-up data of 13 patients with primary cervical malignant melanoma diagnosed by pathology in Affiliated Cancer Hospital of Zhengzhou University were collected from January 2013 to December 2019. Analysis the clinical characteristics, treatment and prognosis. Results: The 13 patients were 30-64 years old, with an average age of (51.1±10.8) years old. According to FIGO 2018 staging system, there were 4 stage Ⅰ patients, 3 stage Ⅱ patients, 1 stage Ⅲ patient, and 5 stage Ⅳ patients. Six patients with stage ⅠA-ⅡA were treated with surgery, of which 2 patients received observation only, 3 patients received chemotherapy after surgery, and one patient received chemotherapy+immunotherapy. Two patients with stage ⅡB to Ⅲ and two patients with stage Ⅳ received radiotherapy + chemotherapy. The remaining 3 patients with stage Ⅳ received a combination of chemotherapy, local radiotherapy, immunotherapy or targeted therapy. The median follow-up time was 12 months (7-84 months), 9 patients died, distant metastasis occurred in 3 cases, and the median overall survival was 38 months. Conclusions: Primary cervical malignant melanoma is a relatively rare but highly malignant tumor with poor prognosis and susceptibility to distant metastasis. Surgical resection is the main treatment modality for early-stage patients, and a combination of immunotherapy and targeted therapy may be a new option for metastatic and unresectable patients.