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[目的]探讨肛管直肠恶性黑色素瘤的诊断、治疗及预后。[方法]回顾性分析16例肛管直肠恶性黑色素瘤的临床资料及随访结果。[结果]16例患者首诊确诊率仅25%(4/16),误诊为直肠肛管癌8例、直肠息肉3例。14例行腹会阴联合切除术,1例局部扩大切除术,1例单纯化疗。随访6个月～17年,11例发生远处转移,12例死亡,至今存活4例。1、3、5年生存率分别为54.5%、20.4%和7.6%,中位生存期18个月。肿瘤浸润越深、临床分期越晚,预后越差(P<0.05)。而不同肿瘤大小、联合治疗与否的患者间预后差异无统计学意义(P>0.05)。[结论]肛管直肠恶性黑色素瘤易误诊,预后差。早期诊断并行手术治疗,有助于改善预后。
[Objective] To investigate the diagnosis, treatment and prognosis of anorectal malignant melanoma. [Methods] A retrospective analysis of 16 cases of anorectal malignant melanoma clinical data and follow-up results. [Results] The first diagnosis rate of 16 cases was only 25% (4/16), misdiagnosed as 8 cases of rectal canal cancer and 3 cases of rectal polyps. 14 cases of abdominal perineal resection, 1 case of local enlargement resection, 1 case of simple chemotherapy. Followed up for 6 months to 17 years, 11 cases of distant metastasis, 12 patients died, so far survived in 4 cases. The 1, 3, 5-year survival rates were 54.5%, 20.4% and 7.6%, respectively. The median survival time was 18 months. The deeper the tumor invasion, the later the clinical stage, the worse the prognosis (P <0.05). There was no significant difference in prognosis between patients with different tumor size and combination therapy (P> 0.05). [Conclusion] Anorectal malignant melanoma is easy to misdiagnosis, the prognosis is poor. Early diagnosis of concurrent surgery, helps to improve the prognosis.