[Clinical features and prognosis of cutaneous melanoma].

Objective: To analyze the clinical features and prognosis of patients with cutaneous melanoma. Methods: The clinical data and follow-up data of 125 patients with cutaneous malignant melanoma (CMM) treated in the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between February 2008 and August 2019 were collected. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for impact factor analysis. Results: Among the 125 patients, 12 were stage Ⅰ, 62 were stage Ⅱ, 30 were stage Ⅲ, and 21 were stage Ⅳ; 76 were acral and 49 were non-acral. The median survival time was 44 months, and the 1-, 2-, and 5-year survival rates were 85.4%, 63.2% and 38.7%, respectively. Kaplan-Meier univariate survival analysis showed that Karnofsky performance status score, tumor stage, primary site, vascular infiltration, Ki-67, BRAF, lactate dehydrogenase (LDH), and surgical treatment were related to the prognosis of patients (P<0.05). The median overall survival (OS) time of patients receiving interferon treatment was 53 months, which was better than 40 months of patients not receiving interferon treatment, but the difference was not statistically significant (P=0.448). Among stage Ⅲ patients, the median OS time of patients receiving interferon therapy was 40 months, which was better than 17 months of patients not receiving interferon therapy (P=0.012). Among stage Ⅱ patients, the 1-, 2-, and 5-year survival rates of acral patients were 97.1%, 84.7%, and 65.8%, and the 1-, 2-, and 5-year survival rates of non-acral patients were 93.3%, 70.0% and 17.0%. The prognosis of patients with stage Ⅱ acral type was better than that of non-acral type (P=0.043). The median survival time of stage Ⅲ patients with acral type was 32 months, better than 17 months of non-acral type, but the difference was not statistical significance (P=0.164). The median survival time of acral type and non-acral type was 8 months and 11 months respectively (P=0.458). Cox multivariate analysis showed that tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma. Conclusions: Interferon treatment can improve the prognosis of patients with stage Ⅲ, and stage Ⅱ acral type patients have better prognosis than that of non-acral type patients. Tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma.目的：探讨皮肤黑色素瘤患者的临床病理特征及预后。 方法：收集2008年2月至2019年8月于华中科技大学同济医学院附属同济医院治疗的皮肤黑色素瘤患者的临床病理资料，生存分析采用Kaplan－Meier法和Log rank检验，影响因素分析采用Cox比例风险回归模型。 结果： 125例患者中，Ⅰ期12例，Ⅱ期62例，Ⅲ期30例，Ⅳ期21例；肢端型76例，非肢端型49例。全组患者中位总生存时间(OS)为44个月，1、2、5年生存率分别为85.4%、63.2%和38.7%。卡氏体力状态评分、肿瘤分期、原发灶部位、脉管浸润、ki－67指数、BRAF基因、术前乳酸脱氢酶(LDH)水平、手术治疗与患者预后有关(均P<0.05)。接受干扰素治疗患者的中位OS(53个月)优于未接受干扰素治疗的患者(40个月，P＝0.448)；Ⅲ期患者中，接受干扰素治疗患者的中位OS(40个月)优于未接受干扰素治疗的患者(17个月，P＝0.012)。Ⅱ期患者中，肢端型患者1、2、5年生存率分别为97.1%、84.7%和65.8%，非肢端型患者1、2、5年生存率分别为93.3%、70.0%和17.0%；Ⅱ期肢端型患者预后优于非肢端型患者(P＝0.043)。Ⅲ期患者肢端型中位OS(32个月)优于非肢端型患者(17个月，P＝0.164)。Ⅳ期患者肢端型中位OS(8个月)短于非肢端型患者(11个月，P＝0.458)。肿瘤分期及术前LDH水平为皮肤黑色素瘤患者预后的独立危险因素(均P<0.05)。 结论：干扰素治疗可以改善Ⅲ期患者预后，Ⅱ期肢端型患者预后优于非肢端型患者，肿瘤分期及术前LDH水平为皮肤黑色素瘤患者预后的独立危险因素。.