论文部分内容阅读
目的 研究头颈部恶性黑色素瘤的临床 ,病理及免疫组织化学特征 ,以提高临床和病理诊断率。方法 收集头颈部恶性黑色素瘤 (除脉络膜外 ) 6 8例 ,其中原发于鼻腔和口腔黏膜 33例 ,头颈部皮肤 35例。发病高峰年龄为 41～ 6 0岁。 5 2例为手术切除标本 ,16例为活检 (咬取、切除 )标本。复习所有患者的临床及病理资料 ,并对 42例进行S 10 0、HMB45和NSE免疫组织化学观察。结果 在6 8例中 ,手术切除者 5 2例 ,其中有 13例行补充放疗 ,2 1例进行了化疗 ;单纯放疗 10例 ;拒绝治疗 6例。在获得随诊的 5 6例中 ,存活 5年以上者 12例 ,其中头颈部皮肤恶性黑色素瘤 9例 ,占 75 0 % ;鼻腔及口腔黏膜者 3例 ,占 2 5 0 %。结论 恶性黑色素瘤在组织学结构上的改变具有重要意义 ;免疫组织化学对恶性黑色素瘤诊断和鉴别诊断有重要价值 ;发生于鼻腔和口腔黏膜的恶性黑色素瘤的预后明显比发生在头颈部皮肤的差。
Objective To study the clinical, pathological and immunohistochemical features of malignant melanoma in head and neck in order to improve the clinical and pathological diagnosis. Methods A total of 68 head and neck malignant melanomas (except choroids) were collected, including 33 cases of primary nasal cavity and oral mucosa, and 35 cases of head and neck skin. The peak age of onset was 41 to 60 years old. In 52 cases, surgical specimens were removed and 16 specimens were biopsy (biting and excision). The clinical and pathological data of all patients were reviewed, and 42 cases of S 10 0, HMB 45, and NSE immunohistochemistry were observed. Results Of the 68 cases, 52 were surgical resections, of which 13 received supplemental radiotherapy, 21 received chemotherapy, 10 received radiotherapy alone, and 6 refused treatment. In 56 patients were followed up in 12 cases survived more than 5 years, wherein the head and neck Melanoma 9 cases 75 0%; the nasal and oral mucosa in 3 cases, 250%. Conclusion The changes of malignant melanoma in the organizational structure of the school is important; immunohistochemistry valuable for tumor diagnosis and differential diagnosis of malignant melanoma; occurred in the nasal and oral mucosa prognosis of malignant melanoma occur in significantly higher than the head and neck skin The difference.