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目的 探讨肛管直肠恶性黑色素瘤 (AMM)合理的治疗方法。方法 回顾性分析我院于 1980～ 1998年确诊治疗的AMM病人 2 8例的临床病理情况、治疗方法及随访结果。生存分析用Kaplan Meier方法 ,生存分布比较用Log rank检验。结果 本组生存期较短 ,5年生存率 7% (2 / 2 8)。经腹直肠肛门切除术 (Miles手术 )与经肛门局部切除术 (LE)比较 ,尽管差异无显著意义 ,但生存期较长的 3例都为Miles术。辅助瘤苗 (BCG)治疗 ,效果较好。淋巴结无转移者生存期较长 ,男女生存期比较差异无显著意义。结论 AMM病人应首先考虑Miles术 ,特别是病灶局限 ,无远处淋巴结及脏器转移的病人 ,并应采用辅助免疫治疗 ,其效果更佳。
Objective To investigate the rational treatment of anorectal malignant melanoma (AMM). Methods Retrospective analysis of the clinical pathology, treatment and follow-up results of 28 AMM patients diagnosed and treated in our hospital from 1980 to 1998. Survival analysis was performed using the Kaplan Meier method and the survival distribution was compared using the Log rank test. Results The shorter survival time in this group was 7% (2/2 8). Compared with transanal local excision (LE), transrectal rectal anusectomy (LE) showed no significant difference, but the longer survival time was Miles. Helper tumor vaccine (BCG) treatment is effective. The survival period of lymph node metastasis was longer, and there was no significant difference in the survival period between men and women. Conclusion Ales patients should first consider Miles surgery, especially the limitations of the lesion, patients with no distant lymph node and organ metastasis, and should use adjuvant immunotherapy, which is better.