Gobbi P G, Cavalli C, Federico M, Bertoloni D, Di Prisco U A, Rossi A, Silingardi V, Mauri C, Ascari E
Department of Internal Medicine and Medical Therapeutics, University of Pavia, Italy.
Lancet. 1988 Mar 26;1(8587):675-9. doi: 10.1016/s0140-6736(88)91477-8.
586 patients with Hodgkin's disease diagnosed between 1970 and 1979 were staged and treated in the same way. Multivariate analysis was used to delineate the prognostic roles of several clinical features at diagnosis. A multiple regression analysis was applied to an exponential model for survival-time distribution, which proved to fit the data accurately. Several clinical characteristics were studied and those that could singly discriminate survival significantly were chosen as predictive variables for the multiple regression. These were: sex, age, stage, histological subtype, presence of constitutional symptoms, mediastinal mass, and erythrocyte sedimentation rate (ESR), and haemoglobin and serum albumin concentrations. ESR, stage, histological subtype, and age proved to be the best prognostic factors, while sex and albumin had minor value. The presence of symptoms, mediastinal bulk, and haemoglobin were not so important. A linear equation for the six variables was derived to calculate the estimated median survival time for any given patient. This equation was validated on an external group of 179 similar patients.
1970年至1979年间确诊的586例霍奇金病患者,采用相同的分期方法并接受相同的治疗。运用多变量分析来确定诊断时几个临床特征的预后作用。对生存时间分布的指数模型进行多元回归分析,结果证明该模型能准确拟合数据。研究了几个临床特征,并将那些能显著单独区分生存情况的特征选为多元回归的预测变量。这些特征包括:性别、年龄、分期、组织学亚型、全身症状的存在、纵隔肿块、红细胞沉降率(ESR)、血红蛋白和血清白蛋白浓度。ESR、分期、组织学亚型和年龄被证明是最佳的预后因素,而性别和白蛋白的价值较小。症状的存在、纵隔肿块大小和血红蛋白的重要性相对较低。推导出了一个包含这六个变量的线性方程,用于计算任何给定患者的估计中位生存时间。该方程在一组179例类似患者的外部样本中得到了验证。