目的探讨103例恶性黑色素瘤的临床特点与病理特征。并将病程作为一个独立研究对象,探讨其与病理特征之间的关系。方法回顾性分析南京鼓楼医院烧伤整形科2010年1月~2018年8月收治的恶性黑色素瘤患者103例,分析其临床特点和病理特征,探讨病程与Breslow厚度、Clark分级之间的关系。结果 103例患者中男48例,女55例,年龄35~86岁,平均63岁;发病年龄以>60岁者居多,共60例(58.25%)。病程小于5年的共71例(68.93%),其中1年以下者30例,1~3年者31例。多数发生于肢端,共95例(92.23%),肿块体积0.6 cm×0.6 cm×0.3 cm~8.0 cm×7.5 cm×3.0 cm。肿瘤细胞大多数处于垂直生长期,少数处于水平生长期,细胞形态多样;多数患者Breslow厚度>4 mm,共 39例(37.86%);Clark分级处于Ⅳ、Ⅴ级者较多,共52例(50.45%)。共41例(54.01%)行免疫组化检测确诊。结论本组MM发病年龄以60岁以上者居多,病程在5年以下者占大多数,好发部位为肢端,肿瘤细胞形态多样,Clark分级多数处于Ⅳ、Ⅴ级,免疫组化检测有助于诊断。
Objective To explore the clinical features and pathological features of 103 cases of malignant melanoma, taking the course of disease as an independent research object, to discuss its relationship with pathological features. Methods 103 patients with malignant melanoma admitted to our department from January 2010 to August 2018 were reviewed to analyze their clinical features and pathological features, and to explore the relationship between disease duration and Breslow thickness and Clark classification. Results Of the 103 patients, 48 were male and 55 were female, aged 35-86 years, with an average age of 63 years;The age of onset was mostly >60 years old [60 cases(58.25%)]. 71 patients(68.93%) had a disease duration shorter than 5 years, including 30 patients under 1 year and 31 patients at 1-3 years. Most melanomas occurred in the extremities [95 cases(92.23%)], and the mass volume was 0.6 cm×0.6 cm×0.3 cm-8.0 cm×7.5 cm×3.0 cm. Most of the tumor cells were in the vertical growth phase, a few were in the horizontal growth phase, and the cell morphology was diverse. Most patients had a Breslow thickness of >4 mm[39 cases(37.86%)];Clark grades were mostly Ⅳ and Ⅴ[52 cases (50.45%)]. A total of 41 cases(54.01%) were diagnosed by immunohistochemistry. Conclusion The age of onset of MM in this group is mostly over 60 years old, and most patients have a disease course of less than 5 years. Most melanomas occur in the extremities, with diverse cell morphology. The Clark grades are mostly Ⅳ and Ⅴ and immunohistochemical detection is helpful for diagnosis.