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原发性食管恶性黑色素瘤的特征与预后

Characteristics and prognosis of primary malignant melanoma of the esophagus.

作者信息

Chen Hengchi, Fu Qiang, Sun Kelin

机构信息

Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Medicine (Baltimore). 2020 Jul 10;99(28):e20957. doi: 10.1097/MD.0000000000020957.

Abstract

Primary malignant melanoma of esophagus (PMME) is a rare malignant tumor of esophagus. This study aimed to investigate the clinic pathologic characteristics and analyze the factors that might affect the prognosis of PMME patients.A total of 20 PMME patients who underwent surgical treatment in our hospital from 1975 to 2017 were analyzed. The clinical data, surgical and pathologic features of all patients were collected.For 20 PMME patients, the average age was 57.3 ± 10.7 years, and the male patients account for 75%. Most of the tumors (95%) were located in the middle and lower of the esophagus. There were 7 patients with primary tumor invasion beyond the muscular layer (T3 + T4) and 10 patients with lymph node metastasis (LNM). The median survival time of 20 patients was 12 months, and the 1-year and 5-year survival rates were 50% and 16.9%, respectively. The probability of LNM in tumors confined to submucosa (T1) and myometrium (T2) was lower than that in tumors with deeper invasion (T3, T4) (P = .035). Multivariate analysis showed that tumor node metastasis (TNM) staging was the independent prognostic factor for survival of PMME patients (hazard ratio [95% confidence interval], 4.15 [1.36-12.67]; P = .012).For PMME patients, tumors with deeper invasion were more likely to have LNM, and TNM staging was an independent predictor of prognosis for survival. Early detection of the disease and radical resection of the tumor are critical for better survival of the PMME patients.

摘要

原发性食管恶性黑色素瘤(PMME)是一种罕见的食管恶性肿瘤。本研究旨在探讨其临床病理特征,并分析可能影响PMME患者预后的因素。

对1975年至2017年在我院接受手术治疗的20例PMME患者进行分析。收集所有患者的临床资料、手术及病理特征。

20例PMME患者的平均年龄为57.3±10.7岁,男性患者占75%。大多数肿瘤(95%)位于食管中下段。有7例患者的原发肿瘤侵犯超过肌层(T3+T4),10例患者有淋巴结转移(LNM)。20例患者的中位生存时间为12个月,1年和5年生存率分别为50%和16.9%。局限于黏膜下层(T1)和肌层(T2)的肿瘤发生LNM的概率低于侵犯更深的肿瘤(T3、T4)(P=0.035)。多因素分析显示,肿瘤淋巴结转移(TNM)分期是PMME患者生存的独立预后因素(风险比[95%置信区间],4.15[1.36-12.67];P=0.012)。

对于PMME患者,侵犯更深的肿瘤更易发生LNM,TNM分期是生存预后的独立预测因素。早期发现疾病并根治性切除肿瘤对PMME患者获得更好的生存至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb9/7360302/315e280a0d00/medi-99-e20957-g002.jpg

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