【作者】 徐迎春；

【导师】 滕理送；

【作者基本信息】 浙江大学 ， 肿瘤学， 2008， 硕士

【摘要】 目的:探讨下肢恶性黑色素瘤(足部为主)的临床表现、病理特点及诊断、治疗(手术、化疗、放疗、生物治疗和转移灶治疗等)和预后情况。方法:回顾性分析11例下肢恶性黑色素瘤患者的临床和病理资料。结果:男性5例,女性6例,平均发病年龄59.6岁。临床表现主要为黑痣增大,其中2例伴反复溃疡、出血,1例伴腹股沟淋巴结肿大。5例患者通过活检确诊,6例患者由术中快速冰冻切片确诊。所有患者均接受手术治疗及辅助治疗。肿瘤分期Ⅰ期3例、Ⅱ期4例,Ⅲ期4例。常规病理检查多可见色素。免疫组化共检测6例,其中HMB45阳性5例,S100阳性6例。11例患者无病生存4到31个月,1例患者在术后4年肺部复发转移。结论:下肢恶性黑色素瘤远处转移率高,预后差。早期发现,早期诊断,早期手术切除,并配合化疗和免疫综合性治疗,可有效提高患者的治愈率及生存率。更多还原

【Abstract】 Objective: To study the clinical features, diagnosis, treatment (including operation, chemotherapy, radiotherapy, biotherapy and metastasis therapy) and prognosis of lower limb malignant melanoma. Methods: 11 patients with lower limb malignant melanoma were analyzed. Results: There were 5 males, 6 females with average age of 59.7 years. Clinical features: With black hemorrhoid increased, two cases of them have repeatedly ulcers and bleeding, one case of them has inguinal lymphadenectasis. Five cases are confirmed by biopsy, six cases by intraoperative frozen section diagnosis. All of them received surgical treatment and adjuvant therapy. Three cases are I stage, four cases are stage II, and four cases are stage III. Routine pathological examination can see visible pigment except one case. Immunohistochemical detection for six cases, includes five cases of positive HMB45, six cases of S100 positive. Eleven cases have survived for four to thirty-seven monthes without recurrence. One case have tumor recurrence and pulmonary metastasis after four years of treatment..Conclusion: Patients with melanoma on lower limb had high distant metastasis rate. Distant metastasis is an important factor that affects the survival rate. The key of malignant melanoma treatment was early diagnosis, early operation combined with chemotherapy and immune therapy.更多还原