Effect of misdiagnosis on the prognosis of anorectal malignant melanoma
Effect of misdiagnosis on the prognosis of anorectal malignant melanoma
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DOI：
10.1007/s00432-010-0793-z
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发表时间：
2010-09-01
影响因子：
3.6
通讯作者：
Wan, Desen
中科院分区：
文献类型：
--
作者：
Zhang, Sen;Gao, Feng;Wan, Desen
肛门直肠恶性黑色素瘤（AMM）是一种常见的误诊疾病。本文分析了1995 ~ 2007年收治的79例AMM患者的误诊情况，其中46例（58.23%）在发病时被误诊，33例（41.77%）在首次就诊后1周内被确诊。误诊的疾病被归类为癌症、痔疮、息肉和其他疾病。采用寿命表和Kaplan-Meier曲线对数据进行统计分析。应用SPSS16.0forWindows统计软件，AMM患者1、2、3、5年生存率分别为58、33、24、16%，中位生存期为14.0个月;误诊患者1、2、3、5年生存率分别为61、22、22、11%，中位生存时间为14.0个月;未误诊患者的1、2、3、5年生存率分别为55%、44%、25%、25%，中位生存时间为12.0个月。基于Kaplan-Meier曲线的分析显示，误诊对AMM患者的生存没有显着影响（P > 0.05）。然而，误诊的疾病对预后影响很大（P = 0.009）;误诊为痔的AMM预后差，1年生存率仅为29%，中位生存期仅为6.0个月，误诊患者预后相对较差，但误诊对预后的影响不显著;但误诊为痔严重影响预后。
Anorectal malignant melanoma (AMM) is frequently subjected to misdiagnosis. Here the effect of misdiagnosis on the prognosis of AMM was investigated.Between 1995 and 2007, 79 patients managed for AMM were reviewed; 46 (58.23%) of them had been misdiagnosed during the symptoms, while 33 (41.77%) cases had been diagnosed exactly not more than 1 week after the first visit. Diseases misdiagnosed were categorized as cancer, hemorrhoids, polyps and other diseases. Data were statistically analyzed by using the life tables and Kaplan-Meier curves. The software used was SPSS 16.0 for Windows.The 1-, 2-, 3- and 5-year survival rates of AMM patients were 58, 33, 24 and 16%, respectively, and the median survival time was 14.0 months; 1-, 2-, 3- and 5-year survival rates of the misdiagnosed patients were 61, 22, 22 and 11%, respectively, and the median survival time was 14.0 months; 1-, 2-, 3- and 5-year survival rates of the patients not misdiagnosed were 55, 44, 25 and 25%, respectively, and the median survival time was 12.0 months. Analyses based on Kaplan-Meier curves revealed no significant effect of misdiagnosis on the survival of AMM patients (P > 0.05). Nevertheless, the diseases misdiagnosed significantly affect the prognosis (P = 0.009); AMM misdiagnosed as hemorrhoids had a poor prognosis, with a 1-year survival rate of only 29% and the median survival of only 6.0 months.The misdiagnosed patients had relatively poor prognosis, but the effect of misdiagnosis on the prognosis was not significant; however, misdiagnosis of AMM as hemorrhoids seriously affected the prognosis.