摘要
目的探讨原发性阴道、外阴恶性黑色素瘤的临床特点。方法回顾性分析天津市肿瘤医院34例原发阴道、外阴恶性黑色素瘤患者的临床资料,并复习中国期刊全文数据库有关文献资料,共247例。结果原发阴道、外阴恶性黑色素瘤发病率低,平均发病年龄52岁,病程6.8个月;首发症状以阴道、外阴肿物(89.1%)、阴道不规则出血(33.2%)、腹股沟肿物(32.4%)及分泌物增多(13.8%)为主;肿瘤部位阴道恶性黑色素瘤多见于阴道下段(60.5%),外阴恶性黑色素瘤多见于大小阴唇、阴蒂及会阴部;Ⅱ、Ⅲ期患者占72.8%,治疗以手术为主(86.2%),辅以化疗、放疗和生物治疗;易复发和转移,远处转移多见于肺、肝脏、腹股沟淋巴结;预后差,5年生存率仅5.4%～27.8%。结论原发阴道、外阴恶性黑色素瘤病期晚,易复发和转移,预后差,治疗以手术为主,早期诊断和治疗是关键。
Objective To investigate clinical features of the primary malignant melanoma of vulva and vagina. Methods We retrospectively analyzed the clinical and followed up data of 34 patients with malignant melanoma of vulva and vagina in cancer hospital of Tianjin medical university from January 1985 to December 2004,and reviewed the pertinent literatures in CNKI. There were totally 247 cases. Results The primary malignant melanoma of vulva and vagina had a low incidence rate. The average age was 52 years old and average course of disease was 6. 8 months. The frequent onset symptoms were vaginal or vulval tumor（89.1%）, irregular bleeding（33.2%）, inguinal tumor（32.4%） and vaginal discharge（13.8%）. Most primary lesions were located at inferior segment of vagina,, labia vulvae, clitoris and perineum. 72.8% of the patients were at stage Ⅱ and Ⅲ. Operation was the best preference, adjunctive therapy mainly included chemotherapy, radiotherapy and biotherapy. Tumor recurrence and metastasis was frequent, the common metastasis was found in lung, liver and inguinal lymph nodes. Its prognosis was low-grade, 5-year survival rate was only 5.4%-27. 8%. Conclusion The primary malignant melanoma of vulva and vagina which have a low-grade prognosis is usually diagnosed lately, and tumor recurrence and metastasis is frequent. Its main therapy is operation. The earlier diagnose and therapy is the key to improve the prognosis.
出处
《中国煤炭工业医学杂志》
2008年第10期1484-1486,共3页
Chinese Journal of Coal Industry Medicine
