头颈部黏膜恶性黑色素瘤的临床分析

目的：探讨并评估头颈部黏膜恶性黑色素瘤（MMHN）的病理、临床特点、治疗方法的效果及其影响愈后的因素。方法：对1985～2009年内收治31例原发性MMHN患者的发病特点,好发部位以及颈淋巴转移的规律以及治疗方法进行回顾性总结分析。结果：好发部位以上颌牙龈和腭部多见,所有患者均行外科手术切除,范围包括原发灶的扩大切除和颈淋巴清扫术,术后1、3、5年的生存率分别为67.74%、54.83%和35.48%,局部复发率48.38%,远处转移率16.12%。结论：早期的诊断和治疗是提高治疗效果的关键;术前切忌切取活检,以术中冰冻病理切片为妥;对术中广泛安全切除和颈淋巴清扫应持积极态度;术后辅助治疗未能显示有肯定性的价值。

Clinical Analysis of the Mucosal Melanoma of Head and Neck

Objective： To study and evaluate the pathology and clinical features of the mucosal melanoma of head and neck（MMHN）.Methods： We retrospectively and comprehensively analysed the clinical manifestations,predilection sites,the discipline of the neck lymphatic transfer and treatment of the 31 primary MMHN patients treated between 1985 and 2009.Results： Upper gums and palate were the common predilection sites.All patients underwent surgical resection,ranging from the extended resection of primary tumor and neck dissection.1,3 and 5-year postoperative survival rates were 67.74 %,54.83% and 35.48%,respectively,while local recurrence rate was 48.38%,and distant metastasis rate was 16.12%.Conclusion： Early diagnosis and treatment is the key of improve treatment effect.Cutting biopsy before surgery should be avoided by all means.It is better to freeze biopsy during operation.Extended and safety resection surgery and neck dissection should be treated positively.Postoperative adjuvant therapy fails to show any positive value.