Sutcliffe S B, Katz D, Stansfeld A G, Shand W S, Wrigley P F, Malpas J S
Lancet. 1978 Jul 8;2(8080):57-60. doi: 10.1016/s0140-6736(78)91377-6.
Tissues obtained by laparotomy and splenectomy from patients with Hodgkin's disease who had received either supradiaphragmatic irradiation for localised disease or combination chemotherapy for advanced disease were examined histologically. 4 of 19 patients considered to be free of abdominal disease after chemotherapy showed residual active Hodgkin's disease; the spleen was the commonest site showing active disease. 2 patients thought to have intra-abdominal disease showed no histological evidence of active disease in the tissue excised. The finding of residual active abdominal disease in patients considered to be in "clinical" remission indicates that the interpretation of the result of treatment depends on the definition of response. A proportion of "relapses" may, in fact, be patients who never achieve genuine remission of disease, whereas the prognosis for those who do achieve complete remission may be even better than currently accepted, and may even amount to "cure". This study shows that histological changes of lymphoreticular tissue can be defined after treatment and may help in determining more accurately the need for further therapy.
对接受过膈上照射治疗局限性疾病或联合化疗治疗晚期疾病的霍奇金病患者，通过剖腹术和脾切除术获取组织进行组织学检查。19例化疗后被认为无腹部疾病的患者中，有4例显示残留活动性霍奇金病；脾脏是显示活动性疾病最常见的部位。2例被认为有腹内疾病的患者，切除组织中未显示活动性疾病的组织学证据。在被认为处于“临床”缓解期的患者中发现残留活动性腹部疾病，这表明治疗结果的解读取决于缓解的定义。事实上，一部分“复发”患者可能是从未真正实现疾病缓解的患者，而那些实现完全缓解的患者的预后可能比目前公认的更好，甚至可能达到“治愈”。这项研究表明，治疗后可确定淋巴网状组织的组织学变化，这可能有助于更准确地确定进一步治疗的必要性。
