中国全科医学2024，Vol.27Issue(8)：942-947,6.DOI:10.12114/j.issn.1007-9572.2023.0307
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
摘要
Abstract
Background Malignant melanoma(MM)is caused by the malignant transformation of epidermal melanocytes with extremely high malignant degree,and its prevention and treatment is a key issue in the field of dermatology.Objective To investigate the prognosis of patients with MM,and 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 subjects.The clinical data were obtained by collecting information from electronic medical records of patients,the overall survival(OS)was confirmed by telephone follow-up,and the last follow-up visit until 2022-12-31.The survival curve was plotted by the Kaplan-Meier method,and Log-rank test was used to compare the survival curves of different influencing factors.Multivariate Cox proportional hazard regression model was used to analyze the influencing factors of survival outcome in MM patients.Results The 1-year overall survival,3-year overall survival,and 5-year overall survival rates of MM patients were 94.6%(194/205),81.9%(168/205)and 72.6%(149/205),respectively,the mean OS was 71.77 months and the median OS was 66.83 months.The results of survival curve analysis showed statistically significant differences when comparing the OS of MM patients with different genders,ages,tumor thicknesses,tumor ulcers,lymph node metastases,and neutrophil-to-lymphocyte ratios(NLR)(P<0.05).Multivariate Cox regression analysis showed that male(HR=1.644,95%CI=1.148-2.498),tumor thickness>1.94 mm(HR=2.466,95%CI=1.419-4.284),tumor ulcer(HR=1.821,95%CI=1.225-2.708),lymph node metastasis(HR=1.999,95%CI=1.305-2.892),and NLR≥3(HR=1.873,95%CI=1.108-3.166)were the influencing factors of survival outcome in MM patients(P<0.05).Conclusion Male,tumor thickness>1.94 mm,tumor ulcer,lymph 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 rate,thus 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分类
医药卫生引用本文复制引用
武淑琴,王远涵,郑凯元,韩红娟,康金秀,余红梅..恶性黑色素瘤患者的预后及影响因素研究[J].中国全科医学,2024,27(8):942-947,6.基金项目
国家自然科学基金面上项目(82273742) （82273742）
