课件：皮肤淋巴瘤诊断和治疗进展.ppt

* The lymph node staging of mycosis fungoides is a process in evolution, but presently, N0 signifies that there are no clinically abnormal, palpable lymph nodes. Patients with clinically palpable lymph nodes are often designated as having stage N1. The designation NP0 refers to patients with lymph node biopsy pathology inconsistent with mycosis fungoides. If a patient has a lymph node biopsy that indicates mycosis fungoides, some authorities recognize the NP1 stage. However, as was mentioned, these lymph node staging recommendations are currently under consideration. * This slide shows lymph node pathology staging. Patients designated with LN1 and LN2 lymph node stages have reactive lymph nodes with, perhaps, very small clusters of malignant T cells within the lymph node. Patients who have LN3 and LN4 lymph node staging have lymph node involvement with cutaneous T-cell lymphoma. These patients often have much larger aggregates of malignant T cells within the lymph nodes and will often show either partial or total effacement of the lymph node. Some data suggest that patients with LN4 grade lymph nodes have a worse prognosis than patients with LN3 grade lymph nodes. * Disease-specific survival curves for patients with CTCL vary by stage. Patients with stage IA disease do not achieve a median survival because their survival is similar to the normal population There is very little overlap of the survival curves based on clinical staging. Therefore, this clinical staging will likely continue to be used in the staging of cutaneous T-cell lymphoma. Stage IV patients have a very short median survival (approximately 2.5 years). Compare that, for example, with stage IB patients who have not reached their median survival, but have a 5-year survival of approximately 85%. Disease-specific survival curves for patients with CTCL, broken down by the various stages, are shown here. Patients with stage IA disease do not achieve a median survival because their survival is similar to t