中华皮肤科杂志 ›› 2022, Vol. 55 ›› Issue (5): 411-416.doi: 10.35541/cjd.20200817

• 研究报道 • 上一篇    下一篇

基于SEER数据库的肢端雀斑样痣黑素瘤预后分析

王海彦    鄢洁    曹馨元    石长青    刘菁    陆晓鸥    张嘉莉    陈宏泉   

  1. 青岛大学附属医院皮肤科，青岛  266003
  • 收稿日期:2020-08-17 修回日期:2020-11-19 发布日期:2022-04-29
  • 通讯作者: 陈宏泉 E-mail:chhq6198@yahoo.com
  • 基金资助:
    青岛市中医药科研计划项目（20-zyy051）

Analysis of prognostic factors for acral lentiginous melanoma based on SEER database

Wang Haiyan, Yan Jie, Cao Xinyuan, Shi Changqing, Liu Jing, Lu Xiaoou, Zhang Jiali, Chen Hongquan   

  1. Department of Dermatology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
  • Received:2020-08-17 Revised:2020-11-19 Published:2022-04-29
  • Contact: CHEN Hong-Quan E-mail:chhq6198@yahoo.com
  • Supported by:
    Qingdao Traditional Chinese Medicine Research Project（20-zyy051）

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摘要： 【摘要】 目的 调查肢端雀斑样痣黑素瘤（ALM）的预后因素，构建列线图验证预测的价值。方法 从美国国立癌症研究所的监测、流行病学、结果（SEER）数据库中收集2004年至2015年共1 537例ALM患者的临床资料，提取年龄、性别、溃疡状态、SEER分期、手术情况、T分期、N分期和M分期与癌症的总生存率和特异生存率数据。应用卡方检验比较患者临床病例特征与总生存率及黑素瘤特异性生存率的相关性，采用单因素及多因素Cox比例风险回归模型探究预后影响因素并且建立预测模型。结果 1 537例ALM中，男714例，女823例，64岁以下818例，白种人1 363例。1 205例皮损出现在下肢和臀部，974例有溃疡；根据SEER分期，1 048例皮损位于局部（未扩散）。不同诊断年龄、性别、溃疡状态、SEER分期、手术情况、T分期、N分期、M分期患者的死亡率差异有统计学意义（均P < 0.001）。单因素、多因素Cox回归分析显示，年龄 ≥ 65岁、男性、有溃疡、SEER分期远处淋巴结转移会增加患者死亡风险（均P < 0.05），T2、T3、T4期患者死亡率高于T1期（均P < 0.05），N1、N2、N3期死亡率高于N0期（均P < 0.05）。结论 年龄、性别、溃疡状态、SEER分期、T分期、N分期为ALM总生存率和特异生存率的独立预后影响因素。

关键词: 黑色素瘤, 肢端雀斑样痣黑素瘤, SEER规划, 预后因素

Abstract: 【Abstract】 Objective To investigate prognostic factors for acral lentiginous melanoma （ALM）, and to construct a nomogram to verify the predictive value of these factors. Methods Clinical data on 1 573 patients with ALM were collected from the Surveillance, Epidemiology, and End Results （SEER）database of National Cancer Institute in United States between 2004 and 2015. Data about patients′ age, gender, ulcer status, SEER staging, surgical protocols, T-, N- and M-staging, overall survival rates and disease-specific survival rates were extracted. Chi-square test was used to analyze the correlation of clinical characteristics with overall survival rates and melanoma-specific survival rates, and univariate and multivariate Cox proportional hazards regression models were used to investigate prognostic factors and establish predictive models. Results Among the 1 537 patients with ALM, 714 were males, 823 were females, 818 were under 64 years of age, and 1 363 were Caucasian. Skin lesions occurred on the lower limbs and buttocks in 1 205 cases, and 974 cases had no ulcers; according to the SEER staging, non-spread localized skin lesions were observed in 1 048 cases. There were significant differences in the mortality rate among patients with different ages at diagnosis, of different gender, ulcer status, surgical status, and at different SEER stages, T-, N- and M-stages （all P < 0.001）. Univariate and multivariate Cox regression analysis showed that age ≥ 65 years, male, ulcers and distant lymph node metastasis in the SEER staging were associated with increased risk of death in the patients （all P < 0.05）, and the mortality rate was significantly higher in the patients with T2-, T3- or T4-stage ALM than in those with T1-stage ALM （all P < 0.05）, and higher in the patients with N1-, N2- and N3-stage ALM than in those with N0-stage ALM （all P < 0.05）. Conclusion Age, gender, ulcer status, SEER stages, T- and N-stages are independent prognostic factors for overall survival rates and disease-specific survival rates of ALM.

Key words: Melanoma, Acral lentiginous melanoma, SEER program, Prognostic factors

引用本文

王海彦 鄢洁 曹馨元 石长青 刘菁 陆晓鸥 张嘉莉 陈宏泉. 基于SEER数据库的肢端雀斑样痣黑素瘤预后分析[J]. 中华皮肤科杂志, 2022,55(5):411-416. doi:10.35541/cjd.20200817

Wang Haiyan, Yan Jie, Cao Xinyuan, Shi Changqing, Liu Jing, Lu Xiaoou, Zhang Jiali, Chen Hongquan. Analysis of prognostic factors for acral lentiginous melanoma based on SEER database[J]. Chinese Journal of Dermatology, 2022, 55(5): 411-416.doi:10.35541/cjd.20200817