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[目的]探讨原发性阴道恶性黑色素瘤的临床病理学特征。[方法]应用免疫组化SP法检测S-100、HMB-45、MART-1及tyrosinase在12例原发性阴道恶性黑色素瘤中的表达情况。[结果]12例原发性阴道恶性黑色素瘤中,S-100阳性表达率为91.7%(11/12),敏感性最高,MART-1、tyrosinase和HMB-45的阳性表达率分别为75.0%(9/12)、75.0%(9/12)和66.7%(8/12)。1例Ⅰ期患者局部切除后复发,再行根治手术和术后辅助化、放疗后无癌生存42个月,11例Ⅱ～Ⅳ期患者中,除1例经根治手术联合放、化疗后生存14个月,余10例均死亡,中位生存时间为22个月。[结论]原发于阴道的恶性黑色素瘤罕见,明确诊断需依赖病理形态学及免疫组化标记。该肿瘤侵袭性强,预后差,至今尚未形成统一模式的治疗方法。
[Objective] To investigate the clinicopathological features of primary vaginal malignant melanoma. [Method] Immunohistochemical SP method was used to detect the expression of S-100, HMB-45, MART-1 and tyrosinase in 12 cases of primary vaginal malignant melanoma. [Results] The positive expression rate of S-100 in 12 cases of primary vaginal malignant melanoma was 91.7% (11/12), the highest sensitivity was found. The positive rates of MART-1, tyrosinase and HMB-45 were 75.0% (9/12), 75.0% (9/12) and 66.7% (8/12). One case of stage Ⅰ patients underwent resection after local excision, followed by radical surgery and postoperative adjuvant chemotherapy. There was no cancer surviving for 42 months after radiotherapy. Of the 11 patients with stage Ⅱ to Ⅳ, 1 patient underwent radical operation and survival after chemotherapy 14 months, more than 10 cases were dead, the median survival time was 22 months. [Conclusion] Malignant melanoma in primary vagina is rare and definite diagnosis depends on pathomorphology and immunohistochemical markers. The tumor is aggressive and has a poor prognosis. So far, no unified model of treatment has been established.