皮肤恶性黑色素瘤预后的影响因素分析

Analysis of prognostic factors for 153 cases of cutaneous malignant melanoma

摘要:

目的 分析影响皮肤恶性黑色素瘤（CMM）预后的因素，为临床治疗及预后预测提供依据。 方法 回顾性分析2009 年1 月-2015 年12 月在新疆医科大学第三临床医学院治疗的153 例CMM 患者的临 床资料及随访情况。以患者性别、年龄、肿瘤溃疡、肿瘤部位、肿瘤厚度、肿瘤分期、BRAF V 600E 突变、 乳酸脱氢酶（LDH）、中性粒细胞与淋巴细胞比值（NLR）、放疗、干扰素治疗为影响因素。分析上述指标对 患者预后的影响，并进行生存分析。结果 单因素分析结果显示，肿瘤溃疡、肿瘤部位、肿瘤厚度、肿瘤分期、 LDH、BRAF V 600E 突变、NLR 为影响CMM 患者预后的因素（P <0.05）。多因素分析结果显示，肿瘤溃疡、 肿瘤厚度、肿瘤分期、NLR 为影响CMM 患者生存时间的独立预后危险因素（P <0.05）。依据独立预后危险 因素综合分析患者的预后，各危险组生存时间比较，差异有统计学意义（P <0.05）。结论 肿瘤溃疡、肿瘤厚 度、肿瘤分期、NLR 为影响CMM 患者预后的独立危险因素。

Abstract:

Objective To analyze the prognostic factors of cutaneous malignant melanoma (CMM) and to provide evidence for clinical treatment and prognosis prediction. Methods The study retrospectively analyzed the clinical data and follow-up data of 153 patients with CMM treated in the Third Clinical Medical College of Xinjiang Medical University between January 2009 and December 2015. The patients’ gender, age, tumor ulcer, tumor site, tumor thickness, tumor stage, BRAF V600E mutation, lactate dehydrogenase (LDH), neutrophil to lymphocyte ratio (NLR), radiotherapy and interferon therapy were taken as the influencing factors. The effect of these indicators on prognosis was observed and statistically analyzed, and a prognostic model was constructed based on multivariate analysis. Results Univariate analysis showed that tumor ulceration, tumor site, tumor thickness, tumor stage, LDH, BRAF V600E mutation and NLR were the factors affecting the prognosis of the patients with CMM (P < 0.05). Multivariate analysis showed that tumor ulceration, tumor thickness, tumor stage and NLR were the independent risk factors affecting the survival time of the patients with CMM (P < 0.05). The prognosis of the patients was analyzed comprehensively based on the independent prognostic risk factors, and there were significant differences in the survival time among the various risk groups (P < 0.05). Conclusions Tumor ulceration, tumor thickness, tumor stage and NLR are the important factors affecting the prognosis of the patients with CMM.