A Retrospective Analysis On Clinicopathological Features And Prognostic Factors Of Conjunctiva Melanoma

Purpose :To investigate the clinicopathologic features and prognostic factors of conjunctiva melanoma,and to provide reference for clinical diagnosis and treatment.Methods:Collected in our hospital from 2003 to 2015 were 46 cases(46 eyes)with complete follow-up process of conjunctiva melanoma patients with clinical data,to summarize its clinical and pathological features,were reviewed and analyzed.The effect of related factors on the prognosis,including age,tumor sources,location,the first visit time,cell types,Ki-67 expression rate,ulcer,surgical methods and so on.Results:In this study,the largest patient was 84 years old,the youngest 25 years old,the average age was 57.6 years old,34 males and 12 females,and the male and female ratio was 2.8:1.0.Multiple sites accounted for the majority of 38 cases(82.6%).Tumor from PAM were 19 cases(41.3%),from nevus were 13 cases(28.3%),from De novo biological were 14 cases(30.4%).Mohs method was used in 23 patients(50%).40 routine immunization group of patients,HMB 45 positive expression of 39 patients(97.5%),S-100 protein positive expression in 40 cases(100%),the positive expression of Ki-67 in 38 cases(95%),Melan A positive expression in 37 cases(92.5%),epithelial cell type in 31 cases(67.4%),spindle cell type in 8 cases(17.4%),7 cases of mixed cell type(15.2%).Recurrence rate,metastasis rate and mortality rate were 47.8%,26.1% and 32.6%,respectively.The risk factors for recurrence were: PAM origin(P=0.0458),and no ulcer(P=0.0191).The risk factors of metastasis and death: first diagnosis for a long time(P=0.0410),occurred recurrence(P=0.0583),metastasis(P < 0.001),without the use of Mohs surgery(P=0.0240),Ki-67 positive expression rate was higher(P = 0.0016).The prognosis of male patients and patients with mixed cell type was even worse,but not statisticallyConclusion: The clinical pathological features and prognostic factors of the patients with conjunctiva melanoma in China are unique.Using Mohs method can improve the survival rate of patients.It is worth popularizing and applying.