摘要
目的探讨皮肤黑色素瘤(CM)患者的预后及其影响因素。方法采用免疫组化法检测481例CM患者的波形蛋白(vimentin)、S100、HMB45、Ki-67、Melan-A表达情况。对CM患者进行随访,根据预后情况将患者分为生存组和死亡组,采用Cox比例风险模型分析CM患者预后的影响因素。结果481例CM患者随访时间为1~132个月,死亡265例,生存216例,总生存率为44.91%。单因素分析结果显示,两组患者的溃疡情况、Clark分级、淋巴结转移情况及S100、Ki-67表达情况比较,差异均有统计学意义(P﹤0.01)。多因素分析结果显示,Clark分级不是影响CM患者预后的因素(P﹥0.05);溃疡、淋巴结转移、S100(+++)、Ki-67≥30%均是影响CM患者预后的危险因素(P﹤0.05)。结论CM患者的预后较差;溃疡、淋巴结转移、S100(+++)、Ki-67≥30%均是影响CM患者预后的危险因素,可用于评估CM患者的预后情况,有助于临床治疗方案的选择及生存率的提高。
Objective To investigate the prognosis and its influencing factors of cutaneous melanoma(CM).Method The expression of vimentin,S100,HMB45,Ki-67 and Melan-A in 481 CM patients were detected by immunohistochemical method.All CM patients were followed up and divided into the survival group and the death group according to the prognosis.The influencing factors of prognosis in CM patients were analyzed by Cox proportional hazards model.Result The 481 patients with CM were followed up for 1-132 months,265 patients died and 216 patients survived,and the overall survival rate was 44.91%.Univariate analysis showed that there were statistically significant differences in ulcer status,Clark grade,lymph node metastasis,S100 expression,Ki-67 expression between the two groups(P<0.01).Multivariate analysis showed that Clark grade was not an influencing factor of prognosis in CM patients(P>0.05),and ulcer,lymph node metastasis,S100(+++)and Ki-67≥30%were risk factors for the prognosis of CM patients(P<0.05).Conclusion The prognosis of CM patients is poor.Ulceration,lymph node metastasis,S100(+++)and Ki-67≥30%are risk factors for the prognosis of CM patients,which can be used to evaluate the prognosis of CM patients and help to select clinical treatment plans to improve the survival rate of patients.
作者
郭婷婷
图荪阿依·吾麦尔
胡佳捷
杨丽丽
GUO Tingting;Tusun’ayi·Wumaier;HU Jiajie;YANG Lili(Department of Pathology,the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang,China;Department of Pathology,Affiliated Cancer Hospital of Xinjiang Medical University,Urumqi 830011,Xinjiang,China)
出处
《癌症进展》
2024年第2期141-145,共5页
Oncology Progress
基金
新疆维吾尔自治区自然科学基金(2022D01C302)。
关键词
皮肤黑色素瘤
预后
影响因素
cutaneous melanoma
prognosis
influencing factor
