Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Seoul, Songpa-gu, Korea.
Arch Dermatol Res. 2024 Nov 22;317(1):42. doi: 10.1007/s00403-024-03496-x.
Prognostic markers are needed for tumor-stage mycosis fungoides (MF) because of their variable prognosis. The objectives of this study were to explore prognostic markers for tumor-stage MF and assess the prognostic significance of clinically assessed MF tumor burden index (MTBI). MTBI was devised to consider the tumor size ≥ 2 cm, number ≥ 5, ulcers, and body surface area ≥ 50%. The prognostic value of MTBI and other potential markers derived from blood tests and skin biopsy were evaluated retrospectively using a tertiary medical center database. We included 38 cases of tumor-stage MF. The mean age was 52.1 years, and the male-to-female ratio was 2.5:1. In multivariable analysis, MTBI ≥ 3 (adjusted hazard ratio, 9.41; 95% confidence interval, 1.13-78.15) was significantly associated with worse disease-specific survival. Ulcers were the only MTBI constituent significantly associated with survival. Among other markers, elevated lactate dehydrogenase level was associated with a worse disease-specific survival. Neutrophil-lymphocyte-ratio, pan-inflammation-value, CD30 positivity, Ki-67 index, large cell transformation, and monoclonal T-cell receptor gene rearrangement were not associated with prognosis. In conclusion, MTBI is useful and promising prognostic marker for tumor-stage MF.
由于肿瘤期蕈样肉芽肿（MF）的预后存在差异，因此需要预测标志物。本研究旨在探索肿瘤期 MF 的预测标志物，并评估临床评估的 MF 肿瘤负担指数（MTBI）的预后意义。MTBI 的设计考虑了肿瘤大小≥2cm、数量≥5、溃疡和体表面积≥50%。使用三级医疗中心数据库回顾性评估了 MTBI 和其他潜在标志物（源自血液检查和皮肤活检）的预后价值。我们纳入了 38 例肿瘤期 MF 患者。平均年龄为 52.1 岁，男女比例为 2.5:1。多变量分析显示，MTBI≥3（调整后的危险比，9.41；95%置信区间，1.13-78.15）与疾病特异性生存率显著降低相关。溃疡是唯一与生存显著相关的 MTBI 成分。在其他标志物中，乳酸脱氢酶水平升高与疾病特异性生存率降低相关。中性粒细胞-淋巴细胞比值、全炎症值、CD30 阳性、Ki-67 指数、大细胞转化和单克隆 T 细胞受体基因重排与预后无关。总之，MTBI 是一种有用且有前途的肿瘤期 MF 预后标志物。
