皮肤黑素瘤70例临床与病理特征分析

目的探讨皮肤黑素瘤的临床和病理特点。方法回顾分析1983-2010年本院病理诊断为皮肤黑素瘤患者的临床资料,重新阅片,再次进行确认诊断和病理分型,对病理诊断不明确者行免疫组化检查,并进行统计学分析。结果皮肤黑素瘤高峰发病年龄为51~60岁,肢端、非肢端部位黑素瘤各占70.00%和30.00%,肢端雀斑样黑素瘤最多,占67.14%,其次为恶性雀斑样痣型黑素瘤(11.43%)和浅表扩散型黑素瘤(10.00%),本研究中结节型仅有3例(4.29%),非暴露与暴露部位在原发损害、原位和侵袭的分布上差异有统计学意义(P=0.045,0.013)。甲下黑素瘤手部明显多于足部(P=0.000)。结论国内黑素瘤发病可能有年轻化趋势;外伤在肢端部位黑素瘤发生中作用有待进一步证实;临床的ABCD标准敏感性较高,可推广使用和作为患者自检的方法。

Cutaneous Malignant Melanoma:Clinicopathological Analysis of 70 Cases

Objective To investigate the clinical and pathological features of cutaneous melanoma. Methods Clinical data of cutaneous melanoma confirmed pathologically from 1983 to 2010 in Peking University First Hospital were retrospectively analyzed by statistical methods. The cases which were pathologically diagnosed indecisively were confirmed by immunohistochemical stain. Results The peak age of onset were the fifth decade of life. Acral and non-acral malignant accounted for 70.00% and 30.00% respectively. The most common pathological subtype was acral lentiginous melanoma(ALM)which accounted 67.14%, following by lentigo maligna melanoma(LMM)and superficial spreading melanoma(SSM)which accounted 11.43% and 10.00% respectively. The subtype of nodular melanoma(NM)was only 3 cases. There were statistical significances between exposed and unexposed location with regard to the primary lesions, and the distribution of invasive or situ(P=0.045,0.013). Subungual melanomas have a predilection for fingers(P=0.000). Conclusion The age of onset of melanoma may have been dropping in chinese people; The relationship between trauma and occurrence of melanoma of acral sites should be confirmed further; The clinical ABCD criteria, which has high sensitivity, can be extended and become the patient self-test method.