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口腔黏膜黑色素瘤的预后因素:82例回顾性队列的组织病理学分析

Prognostic factors of oral mucosal melanoma: histopathological analysis in a retrospective cohort of 82 cases.

作者信息

Song Hao, Wu Yunteng, Ren Guoxin, Guo Wei, Wang Lizhen

机构信息

Department of Oral and Maxillofacial-Head and Neck Oncology, 9th People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.

Department of Oral Pathology, 9th People's Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China.

出版信息

Histopathology. 2015 Oct;67(4):548-56. doi: 10.1111/his.12692. Epub 2015 Apr 21.

Abstract

AIMS

To investigate the histopathological predictors of overall survival and metastatic failure of oral mucosal melanoma (OMM), of which the histopathological classification and microstaging has not been established.

METHODS AND RESULTS

The pathological data, including cell type (CT), level of invasion, ulceration, mitotic rate, pigmentation, necrosis, tumour-infiltrating lymphocyte (TIL) and vascular invasion, of 82 OMM patients from April 2002 to April 2012 were reviewed and analysed retrospectively. CT, ulceration, mitotic rate, pigmentation, necrosis and vascular invasion were found to be of significance in predicting the overall survival of OMM patients. CT was an independent prognostic factor of overall survival in multivariate analysis. In patients with localized OMM, CT, level of invasion, mitotic rate, pigmentation and necrosis were associated with overall survival but none of them proved to be an independent prognostic factor. CT, mitotic rate and TIL were associated with the risk of distant metastasis. TIL was revealed to be an independent factor of distant metastases risk in multivariate analysis.

CONCLUSIONS

CT was an independent prognostic factor of overall survival. Patients with epithelioid cell type OMM had a poor prognosis. Patients without TIL had a higher risk of distant metastasis.

摘要

目的

探讨口腔黏膜黑色素瘤(OMM)总生存期和转移失败的组织病理学预测因素,目前其组织病理学分类和微分期尚未确立。

方法与结果

回顾性分析2002年4月至2012年4月期间82例OMM患者的病理数据,包括细胞类型(CT)、浸润深度、溃疡、有丝分裂率、色素沉着、坏死、肿瘤浸润淋巴细胞(TIL)和血管侵犯情况。发现CT、溃疡、有丝分裂率、色素沉着、坏死和血管侵犯对预测OMM患者的总生存期具有重要意义。在多因素分析中,CT是总生存期的独立预后因素。在局限性OMM患者中,CT、浸润深度、有丝分裂率、色素沉着和坏死与总生存期相关,但均未被证明是独立的预后因素。CT、有丝分裂率和TIL与远处转移风险相关。在多因素分析中,TIL被揭示为远处转移风险的独立因素。

结论

CT是总生存期的独立预后因素。上皮样细胞型OMM患者预后较差。无TIL的患者远处转移风险较高。

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