불명열로 발현한 말초 T-세포 림프종의 임상상
Peripheral T-cell Lymphomas Presenting as Fever of Unknown Origin
대한암학회지 1998년 30권 2호 p.329 ~ 337
소속 상세정보
허대석/Dae Seog Heo
이근석/허주령/방영주/박선양/김철우/김병국/김노경/Keun Seok Lee/Joo Ryung Huh/Yung-Jue Bang/Seon Yang Park/Chul-Woo Kim/Byoung Kook Kim/Noe Kyeong Kim
KMID : 0360319980300020329
Abstract
결론
불명열 발현군은 비불명열 발현군에 비해 진단 당시 진행된 병기에 전신 증상을 잘 동반
하였으며, 신체 활동능력도 낮았다. 비불명열 발현군이 비강 및 부비동을 잘 침범하는데 비
하여, 불명열 발현군은 피부, 위장관, 간의 침범이 많은 소견을 보였다. 또한 불명열 발현군
은 진단이 비불명열 발현군에 비해 어려웠다. 생존 분석 상 2년 생존율이 불명열 발현군은
26%,비불명열 발현군은 67%였으며, 불명열 발현군은 3개월 이내에 74%가 사망하는 등 양
군간에 유의한 차이를 볼 수 있었다(p<0.0001). 예후 인자 분석을 위한 다변수 분석에서도
불명열 발현은 활동도, 병기와 함께 통계적으로 의미 있는 예후 인자로 밝혀졌다. 따라서 불
명열로 발현한 말초 T-세포 림프종은 다양한 말초 T-세포 림프종 중의 한 분류로 간주할
수 있을 것으로 사료되며, 불명열 발현 말초 T-세포 림프종을 특징 지우는 생물학적 인자
를 찾는 연구가 필요할 것이다.
Purpose : Peripheral T-cell lymphomas(PTCL) show diverse clinical and histological
characteristics and should be understood as mixtures of heterogeneous entities. Although
many clinical and biological parameters have been proposed for classifying PTCL into
different prognostic groups, few parameters have turned out to be appropriate for
classification. To investigate the clinical significance of FUO presentation in PTCL,
comparisons of clinical parameters were performed using non-FUO presentation as a
control.
Materials and Methods : 66 cases of Korean PTCL were divided into FUO group and
non-FUO group according to the presentation and compared with each other.
Results : Among 66 patients of PTCL, 19 patients presented with FUO. Compared
with non-FUO group, FUO group showed no significant age and sex ratio differences.
FUO group showed more advanced stage, worse performance status than non-FUO
group. Predominant sites of definite diagnosis were akin, gastrointestinal tract and liver
in FUO group and nasal cavity and paranasal sinus in non-FUO group. There were no
significant differences between histologic classifications of both groups. Survival analysis
revealed significant differences between both groups. FUO group showed significantly
shorter survival. Prognostic factor analysis(multivariate) was done with stage, LDH
level, performance status, and FUO status. FUO status, stage and performance status
were significant determinants of survival, but LDH level proved to have no prognostic
implication.
Conclusion : PTCL with FUO presentation showed such distinct characteristics that
the authors propose fever of unknown origin(FUO) as a clinical parameter for classifying
PTCL. Further studies are needed to identify biological parameters which characterize
PTCL with FUO presentation.
키워드
Lymphoma; 7-cell; Peripheral; Fever of unknown origin; Prognosis;
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