鼻腔鼻窦恶性黑色素瘤的临床诊疗进展

doi:10.6040/j.issn.1673-3770.0.2016.293

摘要/Abstract

摘要： 鼻腔鼻窦恶性黑色素瘤(SMMM)是临床少见的鼻腔鼻窦恶性肿瘤,发病症状通常不典型,就诊时多数患者已属晚期,5年生存率仅为20%~30%。以病理诊断为金标准,组织细胞内发现黑色素颗粒有助于明确诊断,对于无色素型恶性黑色素瘤,免疫组化可帮助鉴别诊断。与Ballantyne分期相比,第7版美国癌症联合委员会(AJCC)头颈黏膜恶性黑色素瘤TNM分期更适用于SMMM。目前,早期SMMM的治疗仍以手术为主,手术加放疗以及生物化疗的综合治疗模式有助于提高患者的生存率。

关键词: 肿瘤分期, 诊断, 恶性黑色素瘤, 鼻腔鼻窦, 治疗

Abstract: Sinonasal mucosal malignant melanoma(SMMM)is a rare sinonasal malignant tumor. Due to the atypical symptoms, most patients were diagnosed as the advanced stage, and the 5-year survival rate is limited to 20%-30%. Pathology is the gold standard for diagnosis. Black pigment particles found in the tissue cells can help the diagnosis; for the non-pigmented melanoma, immunohistochemistry can help to identify the diagnosis. Compared with Ballantyne staging, the 7th edition of American Joint Committee on Cancer(AJCC)malignant melanoma tumor node metastasis(mmTNM)staging may be more suitable for SMMM. At present, the surgical treatment is the first choice for early SMMM, and a comprehensive treatment method, such as surgery combined with radiotherapy and biochemotherapy is favorable to improving the survival rate of patients.

Key words: Malignant melanoma, Diagnosis, Sinonasal, Neoplasms staging, Therapy

中图分类号:

R739.62

王梦君, 李慧,马士崟. 鼻腔鼻窦恶性黑色素瘤的临床诊疗进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 116-120.

参考文献

[1] Gal TJ, Silver N, Huang B. Demographics and treatment trends in sinonasal mucosal melanoma[J]. Laryngoscope, 2011, 121(9):2026-2033.
[2] López F, Rodrigo JP, Cardesa A, et al. Update on primary head and neck mucosal melanoma[J]. Head Neck, 2016, 38(1):147-155.
[3] Pittaka M, Kardamakis D, Spyropoulou D. Comparison of international guidelines on mucosal melanoma of the head and neck: a comprehensive review of the role of radiation therapy[J]. In vivo, 2016, 30(3):165-170.
[4] Vandenhende C, Leroy X, Chevalier D, et al. Sinonasal mucosal melanoma: retrospective survival study of 25 patients[J]. Laryngol Otol, 2012, 126(2):147 -51.
[5] Gilain L, Houette A, Montalban A, et al. Mucosal melanoma of the nasal cavity and paral nasal sinuses[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2014, 131(6):365-369.
[6] Gavriel H, McArthur G, Sizeland A, et al. Review: mucosal melanoma of the head and neck[J]. Melanoma Research, 2011, 21(4):257-266.
[7] Shakhova O, Zingg D, Schaefer SM, et al. SOX10 promotes the formation and maintenance of giant congenital naevi and melanoma[J]. Nat Cel Biol, 2012, 14(8):882 -890.
[8] Liu HG, Kon MX, Yao Q, et al. Expression of Sox10 and c-kit in sinonasal mucosal melanomas arising in the Chinese population[J]. Head and Neck Pathol, 2012, 6(4): 401-408.
[9] Ballantyne AJ. Malignant melanoma of skin of head and neck. An analysis of 405 cases[J]. Am J Surg, 1970, 120(4): 425-431.
[10] Michel J, Perret-Court A, Fakhry N, et al. Sinonasal mucosal melanomas: The prognostic value of tumor classifications[J]. Head & Neck, 2014, 36(3):311-316.
[11] Prasad ML, Patel SG, Huvos AG, et al. Primary mucosal melanoma of the head and neck: a proposal for microstaging localized, stage I(lymph node-negative)tumors[J]. Cancer, 2004, 100(8):1657-1664.
[12] Edge SB, Byrd DR, Compton CC, et al. AJCC cancer staging manual[M]. 7th ed. New York: Springer, 2010: 347-376.
[13] Greene FL. American joint committee on cancer, american cancer society. AJCC cancer staging manual[M]. 6th ed. New York, Springer, 2002.
[14] Samstein RM, Carvajal RD, Postow MA, et al. Localized sinonasal mucosal melanoma: Outcomes and associations with stage, radiotherapy, and positron emission tomography response[J]. Head Neck, 2016, 38(9):1310-1317.
[15] Kuauhyama LO, Madeleine AR, Verónica VV, et al. Comparative study between two different staging systems(AJCC TNM VS BALLANTYNES)for mucosal melanomas of the Head & Neck[J]. Med Oral Patol Oral Cir Bucal, 2016, 21(4):e425-e430.
[16] Shuman AG, Light E, Olsen SH, et al. Mucosal melanoma of the head and neck: predictors of prognosis[J]. Arch Otolaryngol Head Neck Surg, 2011, 137(4):331-337.
[17] Koivunen P, Bäck L, Pukkila M, et al. Accuracy of the current TNM classification in predicting survival in patients with sinonasal mucosal melanoma[J]. Laryngoscope, 2012, 122(8):1734-1738.
[18] Ma R, Li Y, Li J, et al. Clinical analysis of 6 cases with sinonasal malignant melanoma[J]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2015, 29(9):828-831.
[19] 吴云腾, 任国欣, 孙沫逸, 等. 中国头颈黏膜黑色素瘤临床诊治专家共识[J]. 中国口腔颌面外科杂志, 2015, 13(3):262-268. WU Yunteng, REN Guoxin, SUN Moyi, et al. Chinese expert consensus document on head and neck mucosal malignant melanoma[J]. Chin J Oral Maxillofa Surg, 2015, 13(3):262-268.
[20] CSCO黑色素瘤专家委员会. 中国黑色素瘤诊治指南(2013版)[M]. 北京: 人民卫生出版社, 2013: 8-38.
[21] Swegal W, Koyfman S, Scharpf J, et al. Endoscopic and open surgical approaches to locally advanced sinonasal melanoma comparing the therapeutic benefits[J]. JAMA Otolaryngol Head Neck Surg, 2014, 140(9):840-845.
[22] Yu H, Liu G. Clinical analysis of 29 cases of nasal mucosal malignant melanoma[J]. Oncol Lett, 2015, 10(2):1166-1170.
[23] Li W, Yu YL, Wang HL, et al. Evaluation of the prognostic impact of postoperative adjuvant radiotherapy on head and neck mucosal melanoma: a meta-analysis[J]. BMC Cancer, 2015, 15:758.
[24] Meng XJ, Ao HF, Huang WT, et al. Impact of different surgical and postoperative adjuvant treatment modalities on survival of sinonasal malignant melanoma[J]. BMC Cancer, 2014, 14:608.
[25] Lund VJ, Chisholm EJ, Howard DJ, et al. Sinonasal malignant melanoma: an analysis of 115 cases assessing outcomes of surgery, postoperative radiotherapy and endoscopic resection[J]. Rhinology, 2012, 50(2):203-210.
[26] Moreno MA, Roberts DB, Kupferman ME, et al. Mucosal melanoma of the nose and paranasal sinuses, a contemporary experience from the M.D. Anderson Cancer Center[J]. Cancer, 2010, 116(9):2215-2223.
[27] Marta GN, Silva V, Andrade CH, et al. Intensity-modulated radiation therapy for head and neck cancer: systematic review and meta-analysis[J]. Radiother Oncol, 2014, 110(1):9-15.
[28] Askoxylakis V, Hegenbarth P, Timke C, et al. Intensity modulated radiation therapy(IMRT)for sinonasal tumors: a single center long-term clinical analysis[J]. Radia Oncol, 2016, 11:17.
[29] Gore MR, Zanation AM. Survival in sinonasal melanoma: a meta-analysis[J]. J Neurol Surg Skull Base, 2012, 73(3):157-162.
[30] 侯金程, 杨丽辉, 杨琨, 等. 树突状细胞疫苗联合细胞因子诱导的杀伤细胞治疗鼻腔及鼻窦恶性黑色素瘤的近期疗效观察[J]. 临床医学, 2010, 30(1):16-18. HOU Jincheng, YANG Lihui, YANG Kun, et al. Study of the treatment of sinonasal malignant melanoma with DC and CIK[J]. Clin Med, 2010, 30(1):16-18.
[31] 杜楠, 李留树, 肖文华, 等. 生物化疗、化疗或生物疗法用于治疗恶性黑色素瘤的回顾性分析[J]. 中国癌症杂志, 2008, 18(8):573-576. DU Nan, LI Liushu, XIAO Wenhua, et al. Retrospective analysis of biochemotherapy versus chemotherapy or biotherapy for metastatic melanoma[J]. Chin Oncol, 2008, 18(8):573-576.
[32] Bollag G, Tsai J, Zhang J, et al. Vemurafenib: the first drug approved for BRAF-mutant cancer[J]. Nat Rev Drug Discov, 2012, 11(11):873-886.
[33] Hodi FS, O'Day SJ, McDermott DF, et al. Improved survival with ipilimumab in patients with metastatic melanoma[J]. N Engl J Med, 2010, 363(8):711-723.
[34] Chapman PB, Hauschild A, Robert C, et al. Improved survival with vemurafenib in melanoma with BRAF V600E mutation[J]. N Engl J Med, 2011, 364(26):2507-2516.
[35] Guo J, Si L, Kong Y, et al. Phase II, open-label, single-arm trial of imatinib mesylate in patients with metastatic melanoma harboring c-Kit mutation or amplification[J]. J Clin Oncol, 2011, 29(21):2904-2909.
[36] Swaika A, Hammond WA, Joseph RW, et al. Current state of anti-PD-L1 and anti-PD-1 agents in cancer therapy[J]. Mol Immunol, 2015, 67(2Pt A):4 -17.

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