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分析 71 例 HIV 阴性血管滤泡性淋巴结增生症患者的临床特征及预后因素:低蛋白血症是一个不利的预后因素,应适当治疗。

Analysis of clinical characteristics and prognosis factors of 71 cases with HIV-negative Castleman's disease: hypoproteinemia is an unfavorable prognostic factor which should be treated appropriately.

机构信息

Department of Oncology, The First Affiliated Hospital of Zhengzhou University, No 1 Jianshe St., Erqi District, Zhengzhou, 450052, China.

出版信息

J Cancer Res Clin Oncol. 2018 Jul;144(7):1265-1277. doi: 10.1007/s00432-018-2647-z. Epub 2018 May 7.

Abstract

PURPOSE

HIV negative Castleman's disease has been reported as a group of poorly understood lymphoproliferative disorder, and we want to explore the clinical feature and prognosis factors of CD.

METHODS

We retrospectively collected the clinical information of 71 CD patients without HIV infection diagnosed in the first affiliated hospital of Zhengzhou university.

RESULTS

Different clinical classifications, including 35 patients (49.30%) with unicentric Castleman disease and 36 (50.7%) with multicentric Castleman disease, has their specific features compared with each other and unfavorable risk factors calculated by the univariate analysis. As for all of CD patients without HIV infection, there were 7 significant risk factors identified by the results of log-rank test, including clinical complaint, edema (hydrothorax, ascites, pelvic effusion), fatigue, anemia, hypoproteinemia and elevated serum β2-MG. Then, we created a Cox regression model of these clinical and statistic significant factors which indicated hypoproteinemia was an independent poor prognosis factors of CD in both univariate and multivariate analysis.

CONCLUSIONS

Our study emphasized the distinction of clinical characteristics between UCD and MCD and the importance of different poor risk factors of different clinical classifications which may directed more precise and appropriate treatment strategy.

摘要

目的

HIV 阴性血管滤泡性淋巴结增生症(Castleman's disease,CD)被报道为一组尚未完全阐明的淋巴组织增生性疾病,我们希望探讨无 HIV 感染的 CD 患者的临床特征和预后因素。

方法

我们回顾性收集了郑州大学第一附属医院诊断的 71 例无 HIV 感染的 CD 患者的临床资料。

结果

不同的临床分类,包括 35 例(49.30%)局灶性 Castleman 病和 36 例(50.7%)多中心 Castleman 病,与各自的特征和单因素分析计算的不利风险因素有关。对于所有无 HIV 感染的 CD 患者,通过对数秩检验结果确定了 7 个显著的风险因素,包括临床症状、水肿(胸腔积液、腹水、盆腔积液)、疲劳、贫血、低蛋白血症和血清β2-MG 升高。然后,我们根据这些临床和统计学显著的因素建立了 Cox 回归模型,结果表明低蛋白血症是单因素和多因素分析中 CD 的独立不良预后因素。

结论

我们的研究强调了 UCD 和 MCD 之间的临床特征区别,以及不同临床分类的不同不良风险因素的重要性,这可能有助于制定更精确和合适的治疗策略。

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