Thylén A, Hjerpe A, Martensson G
Division of Pulmonary Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Cancer. 2001 Sep 1;92(5):1224-30. doi: 10.1002/1097-0142(20010901)92:5<1224::aid-cncr1441>3.0.co;2-u.
Regardless of the modality of therapy used, malignant pleural mesothelioma is a highly treatment-resistant and invariably fatal disease. Identification of prognostic variables are important for future investigational therapeutic studies.
The prognostic significance of various clinical variables, including hyaluronan levels in pleural fluid, was evaluated in a retrospective analysis in 100 patients with histologically confirmed malignant pleural mesothelioma.
The overall median survival was 11.5 months. Univariate analyses identified histologic subtype, i.e., epithelial or mixed, and elevated content of hyaluronan in the pleural effusion as significant prognostic variables. A multivariate analysis confirmed the independent predictive power of histologic subtype, and an elevated concentration of hyaluronan in the pleural fluid also indicated longer survival in older patients and in patients receiving therapy other than supportive.
The prognostic value of histologic subtype and the concentration of hyaluronan in pleural effusions should be considered when designing and evaluating treatment trials for patients with malignant pleural mesothelioma.
无论采用何种治疗方式，恶性胸膜间皮瘤都是一种极具治疗抵抗性且必然致命的疾病。识别预后变量对于未来的研究性治疗研究很重要。
在一项对100例经组织学确诊的恶性胸膜间皮瘤患者的回顾性分析中，评估了包括胸腔积液中透明质酸水平在内的各种临床变量的预后意义。
总体中位生存期为11.5个月。单因素分析确定组织学亚型，即上皮型或混合型，以及胸腔积液中透明质酸含量升高为显著的预后变量。多因素分析证实了组织学亚型的独立预测能力，并且胸腔积液中透明质酸浓度升高也表明老年患者和接受支持治疗以外治疗的患者生存期更长。
在设计和评估恶性胸膜间皮瘤患者的治疗试验时，应考虑组织学亚型的预后价值以及胸腔积液中透明质酸的浓度。
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