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皮肤继发淋巴瘤:根据淋巴瘤细胞谱系对 106 例患者的临床特征和生存结局进行比较分析。

Secondary cutaneous lymphoma: comparative clinical features and survival outcome analysis of 106 cases according to lymphoma cell lineage.

机构信息

Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnapdong Songpagu, Seoul, 138-736, Korea.

Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnapdong Songpagu, Seoul, 138-736, Korea.

出版信息

Br J Dermatol. 2015 Jul;173(1):134-45. doi: 10.1111/bjd.13582. Epub 2015 Apr 1.

Abstract

BACKGROUND

The relative frequency, clinical features and survival outcomes of secondary cutaneous lymphoma remain poorly understood.

OBJECTIVES

To determine the clinical characteristics and survival outcomes of secondary cutaneous lymphoma.

MATERIALS AND METHODS

The present retrospective cohort study included all 106 patients who presented with secondary cutaneous lymphoma. Patient medical records were reviewed to determine the clinical features, survival outcomes and prognostic factors. Survival outcomes were analysed by using the Kaplan-Meier method and comparisons between lymphoma cell lineages [T or natural killer (T-/NK)-cell vs. B-cell lymphoma] were performed using the log-rank test.

RESULTS

Secondary cutaneous lymphomas consisted of mature T-/NK-cell lymphomas (56%), mature B-cell lymphomas (35%), immature haematopoietic malignancies (8%) and Hodgkin lymphoma (1%). The T-/NK-cell lineage lymphoma cases were more likely to have multiple and disseminated skin lesions than the B-cell lineage lymphoma cases. The lymphoma cell lineage did not significantly influence survival outcomes. Patients who showed cutaneous involvement within 6 months of the initial diagnosis of primary disease had a poorer overall survival (OS) outcome than patients who developed cutaneous dissemination 6 or more months after the initial diagnosis (P < 0.001). Patients with disseminated skin lesions had a poorer OS than patients with localized skin lesions (P = 0.028). The two lymphoma cell lineages differed in terms of prognostic factors that influenced survival.

CONCLUSIONS

Skin lesion characteristics such as time point of appearance and extent affect the survival outcomes of secondary cutaneous lymphoma. Cell lineage did not influence survival outcomes but the two lineages are associated with different prognostic factors.

摘要

背景

继发性皮肤淋巴瘤的相对频率、临床特征和生存结果仍了解甚少。

目的

确定继发性皮肤淋巴瘤的临床特征和生存结果。

材料和方法

本回顾性队列研究纳入了所有 106 例表现为继发性皮肤淋巴瘤的患者。回顾患者的病历记录,以确定临床特征、生存结果和预后因素。采用 Kaplan-Meier 法分析生存结果,并采用对数秩检验比较淋巴瘤细胞谱系(T 细胞或自然杀伤(T-/NK)-细胞与 B 细胞淋巴瘤)。

结果

继发性皮肤淋巴瘤包括成熟 T-/NK 细胞淋巴瘤(56%)、成熟 B 细胞淋巴瘤(35%)、未成熟造血恶性肿瘤(8%)和霍奇金淋巴瘤(1%)。T-/NK 细胞谱系淋巴瘤病例比 B 细胞谱系淋巴瘤病例更有可能出现多发性和播散性皮肤病变。淋巴瘤细胞谱系并未显著影响生存结果。与原发性疾病初始诊断后 6 个月内出现皮肤受累的患者相比,在初始诊断 6 个月或更长时间后出现皮肤播散的患者总体生存(OS)结局更差(P<0.001)。播散性皮肤病变患者的 OS 比局限性皮肤病变患者差(P=0.028)。两种淋巴瘤细胞谱系在影响生存的预后因素方面存在差异。

结论

皮肤病变特征,如出现时间点和范围,影响继发性皮肤淋巴瘤的生存结果。细胞谱系并不影响生存结果,但两种谱系与不同的预后因素相关。

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