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肢端雀斑样痣黑色素瘤:单机构149例临床预后研究

Acral Lentiginous Melanoma: A Clinicoprognostic Study of 149 Cases at a Single Institution.

作者信息

Zheng Xuejing, Wu Wence, Yu Shengji

机构信息

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

出版信息

Am Surg. 2024 Apr;90(4):600-606. doi: 10.1177/00031348231204915. Epub 2023 Sep 26.

Abstract

OBJECTIVE

The objective of this study is to investigate the epidemiological features, clinical characteristics, and pathological characteristics of acral lentiginous melanoma (ALM) and identify prognostic factors.

METHODS

A total of 149 patients diagnosed with ALM between August 2008 and December 2019 at the National Cancer Center (NCC) of China were retrospectively analyzed. Follow-up data on patient survival status were collected. Survival curves were generated using the Kaplan-Meier method, and statistical significance was assessed using the log-rank test. Additionally, a Cox proportional hazards model was constructed to identify prognostic factors.

RESULTS

All patients included in this study were of Chinese ethnicity, with an average age of 52.4 ± 14.8 years (range, 15-80 years) at the time of diagnosis. No gender predilection or genetic susceptibility was observed. The plantar region was the most frequently affected site among primary lesions. Notably, only 17 (11.4%) patients reported a history of trauma. Statistical analysis revealed that a lesion duration of ≤2.5 years, Breslow thickness >4.0 mm, high mitotic rate (>6 mm-2), presence of vascular invasion, and regional lymph node metastasis were identified as independent prognostic factors.

CONCLUSION

Our findings indicate that a lesion duration of ≤2.5 years, Breslow thickness >4.0 mm, high mitotic rate (>6 mm), presence of vascular invasion, and regional lymph node metastasis are significantly associated with a poorer prognosis for patients with ALM.

摘要

目的

本研究旨在探讨肢端雀斑样痣黑色素瘤(ALM)的流行病学特征、临床特征和病理特征,并确定预后因素。

方法

回顾性分析2008年8月至2019年12月在中国国家癌症中心(NCC)诊断为ALM的149例患者。收集患者生存状态的随访数据。采用Kaplan-Meier法生成生存曲线,并使用对数秩检验评估统计学意义。此外,构建Cox比例风险模型以确定预后因素。

结果

本研究纳入的所有患者均为中国汉族,诊断时的平均年龄为52.4±14.8岁(范围15-80岁)。未观察到性别偏好或遗传易感性。足底区域是原发性病变中最常受累的部位。值得注意的是,只有17例(11.4%)患者报告有创伤史。统计分析显示,病变持续时间≤2.5年、Breslow厚度>4.0mm、高有丝分裂率(>6个/mm²)、存在血管侵犯和区域淋巴结转移被确定为独立的预后因素。

结论

我们的研究结果表明,病变持续时间≤2.5年、Breslow厚度>4.0mm、高有丝分裂率(>6个/mm²)、存在血管侵犯和区域淋巴结转移与ALM患者较差的预后显著相关。

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