头颈黏膜恶性黑色素瘤远处转移特点及相关因素分析

郭伟; 尹高菲; 陈晓红; 黄志刚

doi:10.13201/j.issn.1001-1781.2018.14.009

头颈黏膜恶性黑色素瘤远处转移特点及相关因素分析

- 首都医科大学附属北京同仁医院耳鼻咽喉头颈外科(北京, 100010)
基金项目:
国家自然科学基金（No：81670946）；北京市属医院科研培育计划（No：PX2017032）

详细信息

通讯作者: 陈晓红:E-mail:trchxh@163.com; 黄志刚,E-mail:enthuangzhigang@sohu.cn

中图分类号: R739.91

收稿日期: 2018-03-17

Analysis of distant metastasis and related factors of head and neck mucosal melanoma

- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100010, China

More Information

Corresponding authors: CHEN Xiaohong, E-mail: trchxh@163.com ; HUANG Zhigang

Received Date: 17 March 2018

摘要

摘要: 目的：通过分析头颈黏膜恶性黑色素瘤的远处转移特点以及相关因素，为头颈黏膜恶性黑色素瘤的治疗以及患者生存情况的控制予以更好的帮助。方法：回顾性分析我院2004-01-2016-12期间收治的头颈部黏膜恶性黑色素瘤患者，通过随访，对其中37例出现远处转移的患者的病情特点进行分析，包括远处转移的发生率，具体转移部位、时间以及预后情况等。控制患者年龄及性别，在未出现远处转移的患者中随机选择37例组成1：1配比。应用χ²检验，Kaplan-Meier单因素分析以及多因素logistics回归模型分析头颈黏膜恶性黑色素瘤远处转移的相关因素。结果：37例患者病情进展的时间为5~98个月，中位进展时间为18个月。37例患者中死亡27例，存活10例，其中肺转移占32.43%（12/37），腹腔转移占16.22%（6/37），骨转移占5.41%（2/37），存在多脏器转移（肺，肝，脑等）的患者占45.95%（17/37）。行χ²检验，Kaplan_Meier单因素分析显示，病变是否为无色素型，术后放疗，AJCC分期以及手术方式是影响头颈部黏膜恶性黑色素瘤远处转移的显著因素。多因素logistics回归模型明确AJCC分期，病变是否为无色素型与肿瘤远处转移相关。结论：头颈黏膜恶性黑色素瘤的远处转移多发现较晚，发现时多存在广泛的多脏器转移，较少出现脑部转移，多为肺部转移，根据AJCC分期，晚期的患者通常预示着预后不良，术后可能出现远处转移等情况；病理证实为无色素型黑色素瘤的患者，出现远处转移的概率大。
- 头颈部肿瘤 /
- 黏膜黑色素瘤 /
- 远处转移
Abstract: Objective: To analyze the characteristics and related factors of distant metastasis of head and neck mucosal melanoma, so as to provide better help for the treatment and the control of patients' survival. Method: Retrospectively analyze the patients of head and neck mucosal melanoma who were treated in our hospital from January 2004 to December 2016, through follow-up, of which 37 cases of patients with metastatic disease were analyzed which including the incidence of distant metastasis, specific metastasis and prognosis, time, etc.The age and gender of the patients were controlled, and 37 cases of 1:1 were selected randomly in the patients who had no distant metastasis. χ² test, Kaplan-Meier analysis and multiple factor logistics regression model were used to analyze the related factors of distant metastasis of head and neck mucosal melanoma. Result: The time from hospitalization to distant metastasis was 5-98 months, and the median progression time was 18 months. 27 people died in the 37 cases, 10 people were still alive,which lung metastasis accounted for 32.43%(12/37), peritoneal metastasis accounted for 16.22% (6/37), bone metastases accounted for 5.41%(2/37), the presence of multiple organ metastasis (lung, liver, brain) patients accounted for 45.95%(17/37).χ² test and Kaplan_Meier analysis showed that no matter whether there was pigmentation or not, postoperative radiotherapy, AJCC staging and operation mode were the significant factors.Finally,multiple factor logistics regression model showed AJCC staging, and the presence of pigment deposition was associated with metastasis. Conclusion: There is a wide variety of multiple organ metastasis when found.Less brain metastases. According to the AJCC stage, patients with advanced stage usually predict poor prognosis and distant metastasis after operation.The patients' lesion without pigmented melanoma have a great chance of distant metastasis.
- head and neck tumor /
- mucosal melanoma /
- metastasis

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