333例恶性黑色素瘤患者的预后相关因素分析

目的：探讨恶性黑色素瘤的预后相关因素。方法：回顾性分析2007年1月至2011年12月收治的333例恶性黑色素瘤术前患者的临床和病理资料，并对其生存情况进行随访。利用SPSS190统计软件进行分析，Kaplan—Meier法绘制生存曲线，生存率的比较采用log—rank检验，Cox回归对生存情况进行多因素分析。结果：333例恶性黑色素瘤患者男性166例，女性167例，中位年龄55岁，1年、2年生存率分别为44.4％、18.0％。皮肤型及黏膜型为主要的发病类型。多因素分析结果显示：原发部位（P〈0.001）、就诊时有无淋巴结转移（P〈0.001）、LDH水平是否正常（P〈0.001）及是否接受含DTIC方案化疗（P=0.015）对患者的生存期产生影响。而患者的年龄和性别与预后无关。结论：恶性黑色素瘤发病率低，恶性程度高，2年生存率不足20％，不同的原发部位、就诊时有无淋巴结转移、LDH水平是否正常、是否接受含DTIC方案化疗是影响患者预后的因素。早期判断患者的预后，有助于选取适当的治疗方案以进一步延长生存期。

Prognosis factor of 333 cases of malignant melanoma

Objective：To explore clinical characteristics and prognostic factors of malignant melanoma. Methods： The clinicopathological data from 333 patients with malignant melanoma treated in our hospital between January 2007 to December 2011 were retrospectively reviewed,and the survival was observed. Using SPSS 19.0 statistical software for analysis ,the survival curves were calculated by Kaplan - Meier method,log - rank was used for survival analysis, mullivariate analysis of smwival using Cox regression. Results： Of 333 patients with malignant melanoma there were 166 male, 167 female, median age 55 years. 1 year,2 year survival rates were 44.4% , 18.0%. Skin and mucosal type were major type. Multivariate analysis showed, the primary site （P 〈 0. 001 ）, lymph node metastasis （P 〈 0. 001 ） , LDH level （P〈0.001） chemotherapy of DTIC regimen（P =0.015） all have impact on the smwival of patients,regardless of the age and sex of the patient. Conclusion：Malignant melanoma is rare,2 years survival rate is less than 20% , different primary sites,lymph node metastasis, LDH level, DTIC chemotherapy were prognostic factors.