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目的通过回顾性分析口腔黏膜恶性黑色素瘤的病理误诊及颈淋巴结转移特点,为其病理诊断和颈清术式的选择提供参考。方法回顾性分析2001年至2011年间综合治疗的39例口腔黏膜恶黑病例,对其病理误诊及淋巴结转移特点进行回顾性研究。结果 39例口腔黏膜恶黑病例平均发病年龄和男女之比分别为50.4岁、1.05∶1。发病部位以腭部和牙龈多见,其次为颊部及唇部。HE染色病理误诊17例(43.6%)。淋巴结转移多位于I～III区,占总转移部位的89.3%。结论口腔黏膜恶性黑色素瘤病理诊断尽可能HE加免疫组化相结合,避免误诊;对于口腔黏膜恶性黑色素瘤原则上提倡综合治疗,颈清术式宜选择功能性肩胛舌骨上清扫。
Objective To retrospectively analyze the characteristics of misdiagnosis and neck lymph node metastasis of oral mucosal malignant melanoma and provide reference for the pathological diagnosis and choice of neck dissection. Methods Retrospective analysis of 39 cases of oral mucosal malignant melanoma combined treatment from 2001 to 2011, the pathological misdiagnosis and lymph node metastasis were retrospectively studied. Results The average age of onset and the ratio of male to female in 39 cases of oral mucosal malignancy were 50.4 years and 1.05:1 respectively. The incidence of parts of the palate and gums more common, followed by cheeks and lips. 17 cases (43.6%) were misdiagnosed by HE staining. Lymph node metastasis mostly in I ~ III area, accounting for 89.3% of the total metastatic sites. Conclusion Oral mucosal malignant melanoma pathological diagnosis as possible HE plus immunohistochemistry combined to avoid misdiagnosis; for oral mucosal malignant melanoma in principle to promote comprehensive treatment of neck dissection should choose functional supraomolate cleft.