鼻腔鼻窦恶性黑色素瘤23例临床分析

doi:10.6040/j.issn.1673-3770.1.2019.015

摘要/Abstract

摘要： 目的

探讨鼻腔鼻窦恶性黑色素瘤的临床特征、诊断、治疗方法及预后，以提高对该病的诊疗水平。

方法

对南京医科大学第一附属医院2007年10 月至 2018年 9月收治的23例鼻腔鼻窦恶性黑色素瘤的临床资料进行回顾性分析。

结果

23例平均61.7岁，男女比例相仿，肿瘤多发生于鼻腔外侧壁，并常累及上颌窦、额窦和筛窦；治疗后随访6个月~10年，1年生存率为78.26%(18/23)，2年生存率为42.10%(8/19)，3年生存率为20.00%（3/15），5年生存率为11.11%（1/9）。

结论

鼻腔鼻窦恶性黑色素瘤症状隐匿且复杂多变，恶性程度及转移率高，预后差。治疗上提倡广泛的手术切除及术后个体化的化疗、放疗、靶向及生物免疫治疗，早期诊断及综合治疗是提高生存率的关键。

关键词: 黑色素瘤, 鼻腔, 鼻窦, 诊断, 预后, 外科手术, 综合疗法

Abstract: Objective

To explore the clinical features, diagnosis, treatment outcomes, and prognosis of patients with malignant melanoma of the nasal cavity and paranasal sinuses.

Methods

A retrospective review was performed of 23 patients with malignant melanoma of the nasal cavity and paranasal sinuses treated between October 2007 and September 2018.

Results

The average age of the 23 patients was 61.7 years. The proportions of men and women were similar. The tumors mostly occurred in the lateral wall of the nasal cavity and often involved the maxillary, frontal, and ethmoid sinuses. After treatment, the patients were followed-up for 6 months to 10 years. The 1-, 2-, 3-, and 5-year survival rates were 78.26% (18/23), 42.10% (8/19), 20% (3/15), and 11.11% (1/9), respectively.

Conclusion

The symptoms of malignant melanoma of the nasal cavity and sinuses are concealed and complex, with high degrees of malignancy and metastasis and extremely poor prognosis. The treatment strategy includes extensive surgical resection and postoperative individualized chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Early diagnosis and comprehensive treatment can significantly improve the survival rate of malignant melanoma.

Key words: Melanoma, Nasal cavity, Paranasal sinuses, Diagnosis, Prognosis, Surgical procedures, operative, Combined modality therapy

中图分类号:

R765

张佳程,张立庆,周涵,陆美萍,许万云,沈宇杰,刘雅琴,殷敏,董伟达. 鼻腔鼻窦恶性黑色素瘤23例临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 95-99.

Jiacheng ZHANG,Liqing ZHANG,Han ZHOU,Meiping LU,Wanyun XU,Yujie SHEN,Yaqin LIU,Min YIN,Weida DONG. Analysis of malignant melanoma of the nasal cavity and paranasal sinuses in 23 cases[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 95-99.

图/表 2

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