恶性黑色素瘤患者的预后及影响因素研究
Prognosis and Influencing Factors of Patients with Malignant Melanoma
武淑琴 韩红娟 余红梅 康金秀 王远涵 郑凯元
作者信息
摘要
背景 恶性黑色素瘤（MM）由表皮黑色素细胞恶变而成，恶性程度极高，发病率逐年上升，其防治是皮肤病领域的重点课题。目的 探讨恶性黑色素瘤患者的预后情况及其影响因素。方法 选取2006年1月—2021年12月山西医科大学附属第一医院收治的205例肢端MM患者为研究对象。通过收集患者电子病历信息获得临床资料，以电话随访方式确认患者总生存期（OS）。采用Kaplan-Meier法绘制MM患者OS的生存曲线，OS影响因素的单因素分析采用Log-rank检验。采用多因素Cox比例风险回归模型分析MM患者OS的影响因素。结果 截止末次随访（2022-12-31），MM患者1年、3年和5年总生存率分别为94.6%、81.9%、72.6%，患者平均OS为71.77个月，中位生存期为66.83个月。单因素分析结果显示，不同性别、年龄、肿瘤厚度、瘤体溃疡、淋巴结转移、中性粒细胞与淋巴细胞比值（NLR）的MM患者5年总生存率比较，差异有统计学意义（P1.94mm〔HR=2.466，95%CI（1.419，4.284）〕、瘤体溃疡〔HR=1.821，95%CI（1.225，2.708）〕、淋巴结转移〔HR=1.999，95%CI（1.305，2.892）〕、NLR≥3〔HR=1.873，95%CI（1.108，3.166）〕是MM患者OS的影响因素（P1.94mm、瘤体溃疡、淋巴结转移、NLR≥3为影响MM患者不良预后的因素。医务工作者可以重点关注有以上不良预后因素的MM患者，加强护理提高其生存率，从而更好地指导临床。
Abstract
Background Malignant melanomaMMis caused by the malignant transformation of epidermal melanocytes with extremely high malignant degree and increasing incidence rate by yearand its prevention and treatment is a key issue in the field of dermatology. Objective To investigate the prognosis of patients with MMand influencing factors of the prognosis of patients with MM. Methods A total of 205 patients with malignant melanoma from the First Affiliated Hospital of Shanxi Medical University from January 2006 to December 2021 were selected as the subjectsthe clinical data were obtained by collecting information from electronic medical records of patientsthe overall survivalOSwas confirmed by telephone follow-upand the survival curve was plotted by the Kaplan-Meier method. Univariate analysis of the influencing factors of OS was performed by using Log-rank test. Multivariate Cox proportional hazard regression model was used to analyze the influencing factors of OS in MM patients. Results Until the last follow-up visit2022-12-31the 1-year overall survival3-year overall survivaland 5-year overall survival rates of MM patients were 94.6%81.9%and 72.6%respectivelythe mean OS was 71.77 months and the median OS was 66.83 months. The results of univariate analysis showed statistically significant differences when comparing the 5-year overall survival rate of MM patients with different gendersagestumor thicknessestumor ulcerslymph node metastasesand neutrophil-to-lymphocyte ratiosNLRP1.94 mmHR=2.46695%CI1.4194.284tumor ulcerHR=1.82195%CI1.2252.708lymph node metastasisHR=1.99995%CI1.3052.892and NLR ≥ 3HR=1.87395%CI1.1083.166were the influencing factors of OS in MM patientsP1.94 mmtumor ulcerlymph node metastasis and NLR ≥ 3 are poor prognostic factors for MM patients. Medical workers can focus on MM patients with the above poor prognostic factors and enhance care to improve their survival ratethus better guiding the clinic treatment.关键词
恶性黑色素瘤/预后/Cox 模型/列线图/总生存期/影响因素分析/山西省Key words
Malignant melanomas/Prognosis/Cox models/Nomograms/Overall survival/Root cause analysis/Shanxi province引用本文复制引用
武淑琴,韩红娟,余红梅,康金秀,王远涵,郑凯元.恶性黑色素瘤患者的预后及影响因素研究[EB/OL].(2023-07-25)[2026-04-02].https://chinaxiv.org/abs/202307.00699.学科分类
肿瘤学/皮肤病学、性病学
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