口腔黏膜黑色素瘤51例临床分析

目的 探讨口腔黏膜黑色素瘤（oral mucosal melanoma,OMM）的治疗和预后。方法对51例OMM患者的临床资料进行回顾性分析。结果51例中病理证实淋巴结转移31例,其中29例限于Ⅰb～Ⅲ区;本组3、5年生存率分别为35％和21％。切取活检与切除活检、有无色素沉着未显著影响预后;接受手术+生物治疗或生物化疗者生存率显著高于其他治疗模式(P =0.003)。结论OMM颈淋巴结转移主要限于Ⅰb～Ⅲ区;切取活检和色素沉着未显著影响预后;该病预后差,手术+生物治疗或生物化疗有利于改善预后。

Clinical analysis of 51 cases of oral mucosal melanoma

Objective To investigate the treatment and prognosis of the patients with oral mucosal melanoma(OMM). Methods The clinicopathological and follow-up data of patients with OMM in Sun Yat-sen University Cancer Center from January 1976 to December 2005 were analyzed retrospectively.Results Fifty-one cases were analyzed. The pathological lymph node metastasis rate was 61％ (31/51)and the affected sites were confined to level Ⅰb-Ⅲ (94％). The overall three year and five yearsurvival rates were 35％ and 21％ respectively. No significant difference of three year and five year survival rates were found between the group of incisional biopsy and the group of excisional biopsy. The prognosis was not affected by pigmentation. The survival rate of the patients receiving surgery combined with biotherapy or biochemotherapy was significantly higher than that of the patients treated by other modalities ( P = 0. 003 ).Conclusions In patients with OMM, lymph node metastasis was mostly confined to level Ⅰb-Ⅲ. Incisional biopsy and pigmentation were not associated with an unfavorable prognosis. The prognosis of the patients with OMM was poor and the patients may get a better prognosis by receiving surgery combined with biotherapy or biochemotherapy.