肛管直肠恶性黑色素瘤8例临床病理学特征分析

目的 探讨肛管直肠恶性黑色素瘤的临床、内镜及病理学特征,对其诊断进行指导。方法 采用回顾性分析方法分析8例肛管直肠恶性黑色素瘤患者的临床表现、内镜下所见及病理学特征。结果 本次研究的患者共8例,其中男性3例,女性5例,平均年龄为58.63岁;临床病理学分析发现该8名患者的肿瘤结构复杂,细胞形态多样,瘤细胞由上皮样、梭形及未分化小细胞等多种细胞构成;免疫组织化学结果显示S-100(强+)、Vimentin(强+)、HMB45(强+)、MelanA(强+),CK(-)、LCA(-),Ki-67增殖指数为20%~90%。随访时间1～96个月不等,术后1年、2年、5年患者的生存率分别为37.5%、25.0%、12.5%。结论 肛管直肠恶性黑色素瘤临床症状多样,诊断及鉴别诊断依赖内镜下所见及免疫组织化学染色等。肿瘤切除程度与预后密切相关,对所有患者建议术后再进行辅助化疗、免疫治疗及靶向治疗。

Clinicopathological analysis of 8 cases of anorectal malignant melanoma

Objective To investigate the clinicopathological,endoscopic and pathological features of anorectal malignant melanoma,and to guide its diagnosis. Methods A retrospective analysis method was used to analyze the clinical features,endoscopic and pathological features of 8 patients with anorectal malignant melanoma. Results There were 8 patients in this study,including 3 males and 5 females,with an average age of 58.63 years.Clinicopathological analysis revealed that the tumors of the 8 patients were complex in structure and diverse in cell morphology.The tumor cells consisted of epithelioid,spindle-shaped and undifferentiated small cells.immunohistochemistry Results showed: S-100 (strong +),Vimentin (strong +),HMB45 (strong +),MelanA (strong +),CK (-),LCA (-),Ki-67 proliferation index is 20% ~90%.The follow-up time ranged from 1~96 months,and the survival rates of patients at 1 year,2 years,and 5 years after surgery were 37.5%,25.0%,and 12.5%,respectively. Conclusion The clinical symptoms of anorectal malignant melanoma are diverse,and the diagnosis and differential diagnosis rely on microscopic findings and immunohistochemical staining.The degree of tumor resection is closely related to the prognosis.All patients are advised to further adjuvant chemotherapy,immunotherapy and targeted therapy after surgery.