68例肛管直肠黏膜黑色素瘤临床病理特征及预后 Article Swipe
Yisheng Lai
,
Zhigang Li
,
H. Li
,
Yan Wu
,
Yunfei Shi
,
Li Zhou
,
Y T Lou
,
C. Cui
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.19723/j.issn.1671-167x.2023.02.009
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.19723/j.issn.1671-167x.2023.02.009
OBJECTIVE: To investigate the clinicopathological characteristics of anorectal mucosal melanoma (ARMM), and to evaluate the prognostic factors. METHODS: A total of 68 primary ARMM surgical specimens from 2010 to 2018 were retrospectively studied. Slides were reviewed to evaluate pathological features. Slingluff staging method was used for staging. RESULTS: (1) Clinical features: The median age at diagnosis in this group was 61.5 years, with a male-to-female ratio 1 ∶1.62. The most common complaint was blooding (49 cases). For anatomic site, anorectum was the prevalent (66.2%), followed by rectum (20.6%). At the time of diagnosis, 28 cases were stage Ⅰ (localized stage, 41.2%), 25 cases were stage Ⅱ (regional lymph node metastasis, 36.8%), and 15 cases were stage Ⅲ (distant metastasis, 22.1%). Five patients underwent wide local excision, the rest abdominoperineal resection, and 48 patients received adjuvant therapy after surgery. (2) Pathological features: Grossly 88.2% of the tumors were exophytic polypoid masses, with the median tumor size 3.5 cm and the median tumor thickness 1.25 cm. Depth of invasion below lamina muscularis mucosae ranged from 0-5.00 cm (median 1.00 cm). The deepest site of tumor invasion reached muscular layer in 27 cases, and perirectal tissue in 16 cases. Melanin pigmentation was absent or not obvious in 67.6% of the cases. The predominant cytology was epithelioid (45 cases, 66.2%). The rate for ulceration, necrosis, lymphovascular invasion, and perineural invasion was 89.7%, 35.3%, 55.9%, and 30.9%, respectively. The median mitotic count was 18/mm(2). The positive rate of S100, HMB-45 and Melan-A were 92.0%, 92.6% and 98.0%, respectively. The median of Ki-67 was 50%. The incidences of mutations within CKIT, BRAF and NRAS genes were 17.0% (9 cases), 3.8% (2 cases) and 9.4% (5 cases), respectively. (3) Prognosis: Survival data were available in 66 patients, with a median follow-up of 17 months and a median survival time of 17.4 months. The 1-year, 2-year and 5-year overall survival rate was 76.8%, 36.8% and 17.2%, respectively. The rate of lymphatic metastasis at diagnosis was 56.3%. Forty-nine patients (84.5%) suffered from distant metastasis, and the most frequent metastatic site was liver. Univariate analysis revealed that tumor size (>3.5 cm), depth of invasion below lamina muscularis mucosae (>1.0 cm), necrosis, lymphovascular invasion, BRAF gene mutation, lack of adjuvant therapy after surgery, deep site of tumor invasion, and high stage at diagnosis were all poor prognostic factors for overall survival. Multivariate model showed that lymphovascular invasion and BRAF gene mutation were independent risk factors for lower overall survival, and high stage at diagnosis showed borderline negative correlation with overall survival. CONCLUSION: The overall prognosis of ARMM is poor, and lymphovascular invasion and BRAF gene mutation are independent factors of poor prognosis. Slingluff staging suggests prognosis effectively, and detailed assessment of pathological features, clear staging and genetic testing should be carried out when possible. Depth of invasion below lamina muscularis mucosae of the tumor might be a better prognostic indicator than tumor thickness.
Related Topics
Concepts
Medicine
Lymphovascular invasion
Abdominoperineal resection
Perineural invasion
Pathological
Stage (stratigraphy)
Melanoma
Muscularis mucosae
Rectum
Adjuvant therapy
Metastasis
Surgery
Colorectal cancer
Pathology
Cancer
Internal medicine
Cancer research
Biology
Paleontology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://www.ncbi.nlm.nih.gov/pmc/articles/10091247
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10091247/pdf/bjdxxbyxb-55-2-262.pdf
- OA Status
- green
- Cited By
- 1
- References
- 21
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4365135805
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4365135805Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.19723/j.issn.1671-167x.2023.02.009Digital Object Identifier
- Title
-
68例肛管直肠黏膜黑色素瘤临床病理特征及预后Work title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-02-14Full publication date if available
- Authors
-
Yisheng Lai, Zhigang Li, H. Li, Yan Wu, Yunfei Shi, Li Zhou, Y T Lou, C. CuiList of authors in order
- Landing page
-
https://www.ncbi.nlm.nih.gov/pmc/articles/10091247Publisher landing page
- PDF URL
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https://pmc.ncbi.nlm.nih.gov/articles/PMC10091247/pdf/bjdxxbyxb-55-2-262.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://pmc.ncbi.nlm.nih.gov/articles/PMC10091247/pdf/bjdxxbyxb-55-2-262.pdfDirect OA link when available
- Concepts
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Medicine, Lymphovascular invasion, Abdominoperineal resection, Perineural invasion, Pathological, Stage (stratigraphy), Melanoma, Muscularis mucosae, Rectum, Adjuvant therapy, Metastasis, Surgery, Colorectal cancer, Pathology, Cancer, Internal medicine, Cancer research, Biology, PaleontologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2024: 1Per-year citation counts (last 5 years)
- References (count)
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21Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.OBJECTIVE: | 0 |
| abstract_inverted_index.Prognosis: | 282 |
| abstract_inverted_index.Univariate | 343 |
| abstract_inverted_index.assessment | 448 |
| abstract_inverted_index.borderline | 414 |
| abstract_inverted_index.diagnosis, | 92 |
| abstract_inverted_index.incidences | 260 |
| abstract_inverted_index.metastasis | 323 |
| abstract_inverted_index.metastatic | 339 |
| abstract_inverted_index.muscularis | 169, 356, 468 |
| abstract_inverted_index.perineural | 224 |
| abstract_inverted_index.perirectal | 191 |
| abstract_inverted_index.prognosis. | 440 |
| abstract_inverted_index.prognostic | 15, 385, 477 |
| abstract_inverted_index.resection, | 129 |
| abstract_inverted_index.thickness. | 481 |
| abstract_inverted_index.CONCLUSION: | 420 |
| abstract_inverted_index.correlation | 416 |
| abstract_inverted_index.epithelioid | 212 |
| abstract_inverted_index.independent | 401, 436 |
| abstract_inverted_index.investigate | 2 |
| abstract_inverted_index.metastasis, | 109, 118, 334 |
| abstract_inverted_index.predominant | 209 |
| abstract_inverted_index.ulceration, | 219 |
| abstract_inverted_index.Multivariate | 390 |
| abstract_inverted_index.Pathological | 139 |
| abstract_inverted_index.effectively, | 445 |
| abstract_inverted_index.pathological | 38, 450 |
| abstract_inverted_index.pigmentation | 197 |
| abstract_inverted_index.respectively. | 232, 252, 280, 318 |
| abstract_inverted_index.lymphovascular | 221, 361, 394, 429 |
| abstract_inverted_index.male-to-female | 64 |
| abstract_inverted_index.characteristics | 5 |
| abstract_inverted_index.retrospectively | 31 |
| abstract_inverted_index.abdominoperineal | 128 |
| abstract_inverted_index.clinicopathological | 4 |
| cited_by_percentile_year.max | 94 |
| cited_by_percentile_year.min | 90 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 8 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.6200000047683716 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.66880566 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |