Mycosis fungoides: Clinicopathologic relationships, survival, and therapy in 59 patients with observations on occupation as a new prognostic factor
Mycosis fungoides: Clinicopathologic relationships, survival, and therapy in 59 patients with observations on occupation as a new prognostic factor
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蕈样肉芽肿：59 名患者的临床病理关系、生存率和治疗以及职业作为新预后因素的观察
DOI：
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发表时间：
1980
期刊：
影响因子：
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通讯作者：
G. Beck
中科院分区：
文献类型：
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作者：
Steven R Cohen;K. Stenn;I. Braverman;G. Beck
对 59 名蕈样肉芽肿 (MF) 患者的临床病理关系、生存率和治疗进行了回顾。对患者生存率的分析表明，只有在分期设计中同时考虑皮肤和内脏表现时，疾病分期才是重要的预后变量。经典的三阶段模式仅基于湿疹（I）、斑块（II）或皮肤肿瘤（III）的发现，并不是预测生存的重要因素。然而，在扩展模型中纳入淋巴结肿大 (IV) 和器官肿大 (V) 或循环 Sézary 细胞 (VI) 表明，随着疾病阶段的增加，生存概率显着下降。对于原始组织病理学材料可供审查的病例，标本的组织学阶段与皮肤病变的形态之间没有关联。这些数据不利于使用基于组织学标准的分期方案。在本研究过程中采用的 30 种不同类型的治疗中，高剂量电子束优于所有其他物理和化疗方式。在一项考虑职业因素的病例对照研究中，受雇于制造业或建筑业的 MF 患者的风险显着增加（相对风险 = 4.3）。对于那些有工业背景的患者来说，患者的生存率大大降低，这表明该亚组倾向于患有严重的疾病。职业因素可能与蕈样肉芽肿的病因学有关的概念为先前需要进一步评估的致病假说提供了新的维度。
Clinicopathologic relationships, survival, and therapy were reviewed in 59 patients with mycosis fungoides (MF). An analysis of patient survival disclosed that stage of disease was a significant prognostic variable only if both cutaneous and visceral manifestations were considered in the staging design. The classical three‐stage format, based solely on findings of eczema (I), plaques (II), or skin tumors (III), was not a significant factor in predicting survival. However, the inclusion of lymphadenopathy (IV) and organomegaly (V) or circulating Sézary cells (VI) in an expanded model revealed a significant decline in the probability of survival with increasing stage of disease. Regarding cases where the original histopathologic material was available for review, there was no association between the histologic stage of the specimen and the morphology of skin lesions. These data militate against the use of a staging scheme based on histologic criteria. Among 30 different types of treatment employed during the course of this study, highdose electron beam was superior to all other physical and chemotherapeutic modalities. In a case‐control study considering occupational factors, patients with MF who were employed in manufacturing or construction industries were at significantly increased risk (relative risk = 4.3). Patient survival was reduced considerably for those with industrial backgrounds, suggesting that this subgroup was inclined to have severe disease. The concept that occupational factors may be implicated in the etiology of mycosis fungoides provides a new dimension to previous pathogenic hypotheses that needs further evaluation.