日本リンパ網内系学会会誌
Online ISSN : 1883-681X
Print ISSN : 1342-9248
専門病理医の中央診断をうけた非ホジキンリンパ腫447例の重要な予後因子と予後予測に有用な臨床病理
予後分類(Lymphoma Clinico-pathological Prognostic Classification: LCP分類)とLCPスキーマ
下山 正徳向井 清菊池 昌弘須知 泰山難波 紘二森 茂郎渡辺 昌三方 淳男若狭 治毅田島 絹子小鶴 三男鈴木 久三
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38 巻 (1998) 1 号 p. 41-55

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In 447 adults with non-Hodgkin's lymphoma with immunopathological consensus diagnosis by 8 hemato-pathologists accordings to Working Formulation (WF) and T-or B-cell marker, 6 important prognostic factors, age, stage, serum lactate dehydrogenase unit, performance status, T-or B-cell lineage, and WF prognostic grade, were determined by multivariate analysis. Our model, called lymphoma clinico-pathological prognostic (LCP) classification, based on T-or B-cell lineage and WF prognostic grade that were the most important prognostic factors, identified 4 prognostic categories with predictive 5-year survival rates of 73.2% for indolent, 49.3% for aggressive, 18.2% for highly aggressive, and 3.9% for fulminant lymphomas (p<0.0001). In order to facilitate the translation of the Revised European-American Lymphoma (REAL) classification or World Health Organization (WHO) lymphoma classification into a clinically useful grouping, LCP schema is developed, in which the major distinction of lymphomas of B-and T/NK-cell lineage and 3 prognostic categories are defined as indolent, aggressive, and highly aggressive lymphomas. Each category is further subdivided into 3 subcategories by probable curability rate, namely (1) 30% or more patients are cured, (2) 10 to 30% cured, and (3) none or less than 10% cured. The LCP schema is a proposed prognostic grouping of clinically, histopathologically, and genetically defined lymphoma entities, and it will provide tentative guidelines for clinicians and pathologists to reach a widely accepatable basis for further improvements in the diagnosis and management of non-Hodgkin's lymphomas.

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