• 1.四川大學(xué)華西醫(yī)院腫瘤中心放療科（成都610041）;;
  • 2.四川大學(xué)華西醫(yī)院普外科;

目的探討肛管直腸惡性黑色素瘤的診治進(jìn)展。方法復(fù)習(xí)相關(guān)文獻(xiàn)并對本病病因、臨床特點、早期診斷、治療及預(yù)后作一綜述報告。結(jié)果肛管直腸惡性黑色素瘤是一種發(fā)病率很低的惡性腫瘤。發(fā)病原因可能與良性黑痣史，HIV感染，太陽光照射有關(guān)。主要癥狀有便血、局部腫塊、大便習(xí)慣改變等。早期診斷主要依賴對45~80歲的高危發(fā)病人群進(jìn)行常規(guī)直腸檢查。CEA多克隆抗體標(biāo)記陽性在病理診斷中有一定幫助。治療方法現(xiàn)存在爭議，多主張在手術(shù)治療（腹會陰聯(lián)合切除或局部廣泛切除）的基礎(chǔ)上輔以化療、放療或免疫治療。結(jié)論肛管直腸惡性黑色素瘤早期診斷困難，預(yù)后差，應(yīng)提高警惕，最佳治療方法還有待進(jìn)一步探討。

引用本文： 王辛綜述,肖乾虎審校. 肛管直腸惡性黑色素瘤的診治進(jìn)展. 中國普外基礎(chǔ)與臨床雜志, 2002, 9(3): 210-212. doi: 復(fù)制

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15. Turk PS, Belliveau JF, Darnowski JW,et al.Isolated pelvic perfusion for unresectable cancer using a balloon occlusion technique [J]. Arch Surg, 1993; 128(5)∶533.
16. Wanebo HJ, Chung MA, Levy AIM,et al.Preoperative therapy for advanced pelvic malignancy by isolated pelvic perfusion with the balloon occlusion technique [J].Ann Surg Oncol, 1996; 3(3)∶295.
17. Melhouf MM, el Amrani N, Mathieu DH,et al. Anorectal malignant melanomas. Apropos of 5 cases. Review of the literature[J]. Ann Gastroenterol Hepatol Paris,1995; 31(4)∶209.
18. Cooper PH,Mills SE,Alien S.Malignant melanoma of the anas: report of 12 patients and analysis of 255 additional cases [J].Dis Colon Recum,1982; 25（7）∶693.
  1. 1. Cagir B,Whiteford MH, Topham A，et al. Changingepidemiology of anorectal melanoma [J]. Dis Colon Rectum, 1999; 42(9)∶1203.
  2. 2. Delikaris P,Koutmeridis D, Tsonis G,et al. Synchronous anorectal malignant melanoma and rectal adenocarcinoma: report of a case [J]. Dis Colon Rectum, 1997; 40(1)∶105.
  3. 3. Weinstock MA.Epidemiology and prognosis of anorectal melanoma [J]. Gastroenterology, 1993; 104(1)∶174.
  4. 4. Quinn D,Selah C.Malignant melanoma of the anus in a negro:report of a case and review of the literature [J].Dis Colon Rectum, 1977; 20（7）∶627.
  5. 5. Slingluff CL Jr, Vollmer HF, Seigler HF. Anorectal melanoma: clinical characteristics and results of surgical management in twentyfour patients [J].Surgery,1990; 107(1)∶1.
  6. 6. Ross M, Pezzi C,Pezzi T,et al. Patterns of failure in anorectal melanoma. A guide to surgical therapy [J]. Arch Surg, 1990; 125(3)∶313.
  7. 7. Goldman S,Glimelius B,Pahlman L.Anorectal malignant melanoma in Sweeden: report of patients [J].Dis Colon Rectum,1990; 33（10）∶874.
  8. 8. Ben IO, Levy R, Weill S,et al.Anorectal malignant melanoma.A clinicopathologic study including immunohistochemistry and DNA flow cytometry [J]. Cancer, 1997; 79(1)∶18.
  9. 9. Vijayaraghavan M,Kharbanda K, Mathur M. S100 staining for the diagnosis of melanoma of the anal canal [J]. Indian J Pathol Microbiol, 1992; 35(2)∶113.
  10. 10. Wanebo HJ,Woodruff JM,Farr GH,et al.Anorextal melanoma [J].Cancer,1981; 47（7）∶1891.
  11. 11. Thibault C, Sagar P, Nivatvongs S, et al. Anorectal melanomaan incurable disease [J]?Dis Colon Rectum, 1997; 40(6)∶661.
  12. 12. Whooley BP,Shaw P, Astrow AB, et al.Long term survival after locally aggressive anorectal melanoma [J]. Am Surg, 1998; 64(3)∶245.
  13. 13. Vorpahl U, Jager E,Schmidbauer U, et al.Value of inguinal lymph node excision in anorectal melanoma [J]. Zentralbl Chir, 1996; 121(6)∶483.
  14. 14. Brady MS, Kavolius JP,Quan SH. Anorectal melanoma. A 64year experience at Memorial Sloan Kettering Cancer Center [J]. Dis Colon Rectum, 1995; 38(2)∶146.
  15. 15. Turk PS, Belliveau JF, Darnowski JW,et al.Isolated pelvic perfusion for unresectable cancer using a balloon occlusion technique [J]. Arch Surg, 1993; 128(5)∶533.
  16. 16. Wanebo HJ, Chung MA, Levy AIM,et al.Preoperative therapy for advanced pelvic malignancy by isolated pelvic perfusion with the balloon occlusion technique [J].Ann Surg Oncol, 1996; 3(3)∶295.
  17. 17. Melhouf MM, el Amrani N, Mathieu DH,et al. Anorectal malignant melanomas. Apropos of 5 cases. Review of the literature[J]. Ann Gastroenterol Hepatol Paris,1995; 31(4)∶209.
  18. 18. Cooper PH,Mills SE,Alien S.Malignant melanoma of the anas: report of 12 patients and analysis of 255 additional cases [J].Dis Colon Recum,1982; 25（7）∶693.