Sweet D L, Kinnealey A, Ultmann J E
Cancer. 1978 Aug;42(2 Suppl):957-70. doi: 10.1002/1097-0142(197808)42:2+<957::aid-cncr2820420719>3.0.co;2-d.
The preferred histopathological classification of Hodgkin's disease (HD) is that suggested by Lukes and Butler as modified at the Rye Symposium; the histologic subtypes are highly reproducible and correlate well with the anatomic sites of involvement, clinical stage, and survival. The accuracy of the bipedal lymphangiogram, 67gallium scan, and ultrasonography in predicting abdominal involvement by HD is 90% , 50%, and 88%, respectively. Staging laparotomy remains the most accurate method of detecting intra-abdominal disease and has added immensely to new concepts in the management of HD. These concepts suggest that patients with nodal disease limited to the celiac axis or upper para-aortic areas (substage III1) or pathologic stage (PS) IIIS+N-A, when treated with extended field radiotherapy alone have survival rates comparable to PS IIA patients. In contrast, patients in PS IIIA with lower abdominal nodal disease (substage III2), regardless of splenic involvement, have a prognosis comparable to PS IV disease. Thus, there may only be two stages of HD, those curable with extended mantle or smaller radiotherapy fields alone, and those requiring chemotherapy with or without supplemental radiotherapy.
霍奇金病（HD）首选的组织病理学分类是由卢克斯和巴特勒提出并经瑞伊研讨会修订的分类；组织学亚型具有高度可重复性，且与受累的解剖部位、临床分期及生存率密切相关。双足淋巴管造影、镓-67扫描及超声检查预测HD腹部受累的准确率分别为90%、50%和88%。分期剖腹术仍然是检测腹腔内疾病最准确的方法，极大地丰富了HD治疗的新概念。这些概念表明，局限于腹腔动脉轴或主动脉旁上部区域的淋巴结疾病（Ⅲ1亚期）或病理分期（PS）为IIIS+N-A的患者，仅接受扩大野放射治疗时，其生存率与PS IIA患者相当。相比之下，PS IIIA伴有下腹部淋巴结疾病（Ⅲ2亚期）的患者，无论有无脾受累，其预后与PS IV期疾病相当。因此，HD可能仅分为两个阶段，即仅用扩大的斗篷野或较小的放射治疗野即可治愈的阶段，以及需要化疗联合或不联合补充放疗的阶段。
