Kim T M, Lee S-Y, Jeon Y K, Ryoo B-Y, Cho G J, Hong Y S, Kim H J, Kim S-Y, Kim C S, Kim S, Kim J S, Sohn S K, Song H H, Lee J L, Kang Y K, Yim C Y, Lee W S, Yuh Y J, Kim C W, Heo D S
Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine.
Department of Pathology, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine.
Ann Oncol. 2008 Aug;19(8):1477-1484. doi: 10.1093/annonc/mdn147. Epub 2008 Apr 2.
This national survey was undertaken to propose the classification of extranodal natural killer (NK)/T-cell lymphoma (NTCL) subtypes and to clarify a clinical heterogeneity.
Two hundred and eighty patients newly diagnosed as NTCL were enrolled from 22 Korean medical centers. Two subsets were compared: one involving the upper aerodigestive tract (UAT) and another involving the non-upper aerodigestive tract (NUAT) region, which comprises the skin, gastrointestinal tract, and liver or soft tissues. Clinical prognostic factors, survival outcomes, and independent predictors for survival were compared between each subset.
NUAT-NTCL (59 patients) had significantly higher proportions of disseminated disease, aggressive biologic features, and unfavorable host reactions compared with UAT-NTCL (221 patients). NUAT-NTCL had shortened 5-year overall survival (OS) (22% versus 41%, P = 0.001). Ann Arbor staging, the International Prognostic Index, and the NTCL prognostic index failed to predict the OS of NUAT-NTCL, but did predict the OS in UAT-NTCL. Independent predictors for OS by multivariate analyses differed between each subset. In the NUAT subset, extranodal sites and regional nodes predicted the OS, while Ann Arbor staging, age, performance status, and lactate dehydrogenase level predicted the OS in the UAT subset.
NUAT-NTCL may represent a distinctive disease entity in terms of clinical factors, independent predictors, and survival outcomes.
开展这项全国性调查旨在提出结外自然杀伤（NK）/T细胞淋巴瘤（NTCL）亚型的分类方法，并阐明其临床异质性。
从22家韩国医疗中心招募了280例新诊断为NTCL的患者。比较了两个亚组：一个涉及上呼吸消化道（UAT），另一个涉及非上呼吸消化道（NUAT）区域，后者包括皮肤、胃肠道、肝脏或软组织。比较了每个亚组的临床预后因素、生存结果及生存的独立预测因素。
与UAT-NTCL（221例患者）相比，NUAT-NTCL（59例患者）的播散性疾病比例、侵袭性生物学特征及不良宿主反应比例显著更高。NUAT-NTCL的5年总生存率（OS）缩短（22%对41%，P = 0.001）。Ann Arbor分期、国际预后指数及NTCL预后指数未能预测NUAT-NTCL的OS，但能预测UAT-NTCL的OS。多因素分析得出的OS独立预测因素在每个亚组中有所不同。在NUAT亚组中，结外部位和区域淋巴结可预测OS，而在UAT亚组中，Ann Arbor分期、年龄、体能状态及乳酸脱氢酶水平可预测OS。
就临床因素、独立预测因素及生存结果而言，NUAT-NTCL可能代表一种独特的疾病实体。
