Aozasa K, Ohsawa M, Iuchi K, Mori T, Komatsu H, Tajima K, Minato K, Tajima K, Shimoyama M
Department of Pathology, Nara Medical University, Kashihara.
Jpn J Clin Oncol. 1991 Dec;21(6):417-21.
Prognostic factors in 47 patients with pleural lymphocytic lymphoma developing in chronic tuberculous pyothorax were evaluated using Cox's proportional hazards model. There were 41 men and six women, aged 44-80 (median 61) years. Approximately 70% of the patients had localized disease in Stages I and II, and 30% advanced disease in Stages III and IV. Histologically, 27 patients had the diffuse large, immunoblastic type and 12 had others. In the other seven patients, histological subtyping of the lymphocytic lymphoma was impossible because of degenerative or necrotic changes in the histologic specimens. A diagnosis of lymphocytic lymphoma of B-cell type was made in one case using combined cytologic and surface maker findings on a cell suspension. In addition, immunologic and immunohistochemical studies revealed another 40 cases to be proven B-cell lymphomas. Poor performance status and elevated levels of BUN and GPT were significantly associated with shortened survival in a Cox's proportional hazards model. A poor performance status and high levels of serum BUN and GPT suggested a marked deterioration in a patient's condition. When compared with previous literature describing prognostic factors in patients with B-cell lymphomas and with lymphocytic lymphomas with unfavorable histologies or associated with long-standing inflammations, the only common prognostic factors was performance status. The significance of primary site in predicting survival from lymphocytic lymphoma is discussed.
采用Cox比例风险模型对47例在慢性结核性脓胸基础上发生的胸膜淋巴细胞性淋巴瘤患者的预后因素进行了评估。患者中男性41例,女性6例,年龄44 - 80岁(中位年龄61岁)。约70%的患者处于Ⅰ期和Ⅱ期局限性病变,30%处于Ⅲ期和Ⅳ期进展期病变。组织学上,27例为弥漫大细胞、免疫母细胞型,12例为其他类型。另外7例患者,由于组织学标本出现变性或坏死改变,无法进行淋巴细胞性淋巴瘤的组织学亚型分类。1例通过对细胞悬液进行细胞学和表面标志物联合检测诊断为B细胞型淋巴细胞性淋巴瘤。此外,免疫及免疫组化研究证实另外40例为B细胞淋巴瘤。在Cox比例风险模型中,体能状态差以及血尿素氮(BUN)和谷丙转氨酶(GPT)水平升高与生存期缩短显著相关。体能状态差以及血清BUN和GPT水平高提示患者病情明显恶化。与既往描述B细胞淋巴瘤患者以及组织学不良或与长期炎症相关的淋巴细胞性淋巴瘤患者预后因素的文献相比,唯一共同的预后因素是体能状态。本文还讨论了原发部位在预测淋巴细胞性淋巴瘤生存方面的意义。