刘庆浩 龙志强 黄伟明 商学谦 李简

    [摘要] 目的 探讨食管恶性黑色素瘤的临床特征、诊断、治疗和预后。 方法 回顾性分析2013年1月～2017年5月北京大学第一医院收治的6例食管恶性黑色素瘤患者的临床资料，并对所有患者进行随访。 结果 6例患者，平均年龄57.7岁，其中男4例，女2例。肿瘤位于中段2例、下段4例。内镜活检误诊2例，确诊需结合病理切片和免疫组化。6例均接受手术治疗，1例单纯手术治疗，5例行术后辅助治疗。术后病理分期，Ⅰ期2例，Ⅱ期3例，Ⅲ期1例。其中1例术后21个月行肺转移瘤切除，术后60个月随访存活。患者生存时间8～60个月，中位生存期18个月。 结论 食管恶性黑色素瘤是一种罕见高度侵袭性的恶性肿瘤，早期诊断和早期治疗可以改善预后，经过严格挑选的病例，转移瘤的切除也有生存获益。免疫靶向治疗的进展，能改善更多患者的预后，值得进一步研究。

    [关键词] 食管；恶性黑色素瘤；手术；预后

    [中图分类号] R735 [文献标识码] A [文章编号] 1673-7210(2018)08(b)-0109-04

    [Abstract] Objective To investigate the clinical features， diagnosis， treatment and prognosis of malignant melanoma of the esophagus. Methods Clinical data of 6 patients with malignant melanoma of the esophagus admitted to Peking University First Hospital from January 2013 to May 2017 were retrospectively analyzed and all patients were followed up. Results The average age of the 6 patients was 57.7 years old， 4 males and 2 females. There were 2 cases in the middle segment of the esophagus and 4 cases in the lower part of the esophagus. There were 2 cases misdiagnosed by endoscopic biopsy， and definite diagnosis need pathological section and immunohistochemistry method. All the 6 cases undertwent surgery ......