弥漫性大 B 细胞淋巴瘤中的胸腔积液：临床和预后意义。
Pleural Effusions in Diffuse Large B-Cell Lymphoma: Clinical and Prognostic Significance.
机构信息
Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLleida, Lleida, Spain.
Service of Hematology, Arnau de Vilanova University Hospital, Lleida, Spain.
出版信息
Lung. 2019 Feb;197(1):47-51. doi: 10.1007/s00408-018-0182-y. Epub 2018 Nov 30.
PURPOSE
Pleural effusion (PEs) may complicate diffuse large B-cell lymphomas (DLBCL). However, their real prevalence and prognostic significance have seldom been approached systematically.
METHODS
Retrospective single-center evaluation of consecutive patients with DLBCL was conducted. Baseline characteristics, PEs on CT imaging, pleural fluid analyses, and outcome until death or censoring date were collected.
RESULTS
Of 185 DLBCL patients, 55 (30%) had PEs, of which 27 (49%) were analyzed. Most tapped PEs were malignant (n = 24) and cytological and/or flow cytometric analyses provided the diagnosis in about 70% of the cases. Malignant PEs were exudates with adenosine deaminase levels > 35 U/L in 35% of the cases. More than one-third of lymphomatous PEs required definitive pleural procedures for symptomatic relief. PEs greater than 200 mL on CT scans were an independent predictor of poor survival in Cox regression modeling (hazard ratio 1.9).
CONCLUSIONS
PEs are common in DLBCL and foreshadow a poor prognosis.
目的
胸腔积液（PEs）可能使弥漫性大 B 细胞淋巴瘤（DLBCL）复杂化。然而，它们的实际患病率和预后意义很少被系统地研究。
方法
对连续的 DLBCL 患者进行回顾性单中心评估。收集基线特征、CT 成像上的 PEs、胸腔积液分析以及直至死亡或截止日期的结果。
结果
在 185 例 DLBCL 患者中，55 例（30%）有 PEs，其中 27 例（49%）进行了分析。大多数抽取的 PEs 是恶性的（n=24），细胞学和/或流式细胞术分析约在 70%的病例中提供了诊断。35%的情况下，恶性 PEs 为渗出液，腺苷脱氨酶水平>35 U/L。超过三分之一的淋巴瘤性 PEs 需要进行明确的胸膜处理以缓解症状。CT 扫描上 PEs 大于 200ml 是 Cox 回归模型中不良生存的独立预测因素（危险比 1.9）。
结论
PEs 在 DLBCL 中很常见，并预示着预后不良。
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