van de Molengraft F J, Vooijs G P
Institute of Pathology, University of Nijmegen, The Netherlands.
Acta Cytol. 1989 Nov-Dec;33(6):911-6.
For a better understanding of the prognosis after the onset of a malignancy-associated effusion in patients known or subsequently shown to have cancer, survival time was compared with the findings and the date of the first cytologic diagnosis of an effusion. The number of patients studied was 254; 171 had a pleural and 83 a peritoneal effusion. The average survival time was 25.5 weeks, which was about equal for both sites of effusions. After two years, only 6% of all patients were alive. When the cytologic diagnosis of the effusion was "malignant," only 4% survived after two years; when the cytologic diagnosis was "suspicious for malignancy" and "nonmalignant," these figures were 5% and 7%, respectively. This indicates that a cytologic diagnosis of benign or nonmalignant is not a good indicator of a better prognosis in cancer patients for whom benign causes of the effusion have been excluded. There appeared to be a prognostic relationship between the length of the interval from the initial diagnosis of cancer to the time of examination of the first sample of the effusion: a longer interval was correlated with a better survival. When survival time was viewed in relation to therapy, patients whose pleural effusions were only treated by aspiration were found to have a particularly short average survival (13.9 weeks).
为了更好地了解已知患有癌症或随后被诊断患有癌症的患者发生恶性肿瘤相关性胸腔积液后的预后情况,将生存时间与胸腔积液首次细胞学诊断的结果和日期进行了比较。研究的患者数量为254例;其中171例有胸腔积液,83例有腹腔积液。平均生存时间为25.5周,两个积液部位的平均生存时间大致相同。两年后,所有患者中只有6%存活。当胸腔积液的细胞学诊断为“恶性”时,两年后只有4%的患者存活;当细胞学诊断为“疑似恶性”和“非恶性”时,这两个数字分别为5%和7%。这表明,在排除了胸腔积液的良性病因的癌症患者中,细胞学诊断为良性或非恶性并不是预后较好的良好指标。从癌症的初始诊断到首次检查胸腔积液样本的时间间隔长度之间似乎存在预后关系:间隔时间越长,生存率越高。当从治疗的角度来看生存时间时,发现仅通过胸腔穿刺治疗胸腔积液的患者平均生存时间特别短(13.9周)。