Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Leuk Lymphoma. 2011 Aug;52(8):1517-22. doi: 10.3109/10428194.2011.574759. Epub 2011 May 17.
This study investigated the prognostic factors of Castleman disease (CD) and focused specifically on multicentric CD (MCD). Seventy patients with CD were studied. Forty-three patients (61.5%) had unicentric CD (UCD) and 27 patients (38.5%) had MCD. Thirty-six patients with UCD (83.7%) underwent surgical excision, and 25 patients with MCD (92.6%) received systemic treatment, including corticosteroids and combination chemotherapy. In the patients with MCD, age >60 years and the presence of splenomegaly were prognostic factors for progression-free survival (hazard ratio [HR] 9.01, 95% confidence interval [CI] 2.64-30.83 and HR 4.32, 95% CI 1.16-16.09) as well as overall survival (OS) in MCD (HR 8.7, 95% CI 2.83-26.84 and HR 2.9, 95% CI 0.95-9.02, respectively). Patients ≤ 60 years old without splenomegaly showed better OS than patients > 60 years old or with splenomegaly (71.4% vs. 10.8% for 5-year OS). MCD might be dissected clinically by the simple parameters of age and presence of splenomegaly.
本研究探讨了血管滤泡性淋巴结增生症（CD）的预后因素，特别关注多中心 CD（MCD）。研究了 70 例 CD 患者。43 例患者（61.5%）为单中心 CD（UCD），27 例患者（38.5%）为 MCD。36 例 UCD 患者（83.7%）接受了手术切除，25 例 MCD 患者（92.6%）接受了全身治疗，包括皮质激素和联合化疗。在 MCD 患者中，年龄>60 岁和脾肿大是无进展生存（风险比[HR]9.01，95%置信区间[CI]2.64-30.83 和 HR 4.32，95%CI 1.16-16.09）和总生存（OS）的预后因素（HR 8.7，95%CI 2.83-26.84 和 HR 2.9，95%CI 0.95-9.02）。年龄≤60 岁且无脾肿大的患者 OS 优于年龄>60 岁或有脾肿大的患者（5 年 OS 分别为 71.4%和 10.8%）。MCD 可能通过年龄和脾肿大这两个简单的参数在临床上进行区分。
