表 1.
患者一般临床资料
General clinical data of patients
| Items | Total (n=63) | Survivors (n=38) | Non-survivors (n=25) |
| Results are presented as mean ± SD (x±s), median (first quartile, third quartile) and numbers (%). Numbers in square brackets indicate the amount of missing values. BMI, body mass index; PNP, paraneoplastic pemphigus; CD, Castleman disease; PDAI, pemphigus disease area index; DSG, desmoglein; BP, bullous pemphigoid; BO, bronchiolitis obliterans; WBC, white blood cell; PaCO2, partial pressure of carbon dioxide in artery; OI, oxygenation index; Hgb, hemoglobin; APACHE, acute physiology and chronic health evaluation; SOFA, sequential organ failure assessment; PCT, procalcitonin; MVT, mechanical ventilation time; ICU, intensive care unit; LHS, the length of hospital stay. | |||
| Baseline characteristics | |||
| Age/years, x±s | 41.7±16.2 | 39.6±16.3 | 46.8±14.8 |
| Age>40 years | 33 (52.4%) | 16 (42.1%) | 17 (68.0%) |
| Male | 25 (39.7%) | 16 (42.1%) | 9 (36.0%) |
| BMI /(kg/m2), x±s | 20.6±3.3 | 20.5±3.1 | 20.8±3.5 |
| Preoperative weight loss>5 kg | 41 (65.1%) | 20 (52.6%) | 21 (84.0%) |
| Preoperative comorbidities | 10 (15.9%) | 6 (15.8%) | 4 (16.0%) |
| Coronary heart disease | 5 (7.9%) | 3 (7.9%) | 2 (8.0%) |
| Hypertension | 7 (11.1%) | 6 (15.8%) | 1 (4.0%) |
| Diabetes | 3 (4.8%) | 1 (2.6%) | 2 (8.0%) |
| Cerebral infarction | 3 (4.8%) | 2 (5.3%) | 1 (4.0%) |
| Chronic bronchitis | 4 (6.3%) | 2 (5.3%) | 2 (8.0%) |
| Smoking | 4 (6.3%) | 2 (5.3%) | 2 (8.0%) |
| Preoperative albumin/(g/L), x±s | 30.9±4.7 | 32.3±3.7 | 26.8±5.0 |
| Preoperative data of PNP | |||
| Tumor location | |||
| Mediastinum | 31 (49.2%) | 17 (44.7%) | 14 (56.0%) |
| Lung | 1 (1.6%) | 1 (2.6%) | 0 (0.0%) |
| Abdominal cavity | 11 (17.5%) | 7 (18.4%) | 4 (16.0%) |
| Pelvis cavity | 8 (12.7%) | 5 (13.2%) | 3 (12.0%) |
| Post-peritonium | 10 (15.9%) | 7 (18.4%) | 3 (12.0%) |
| Multiple tumors | 2 (3.2%) | 1 (2.6%) | 1 (4.0%) |
| Pathological type | |||
| CD hyaline vascular | 40 (63.5%) | 26 (68.4%) | 14 (56.0%) |
| CD plasmacytic | 2 (3.2%) | 0 (0.0%) | 2 (8.0%) |
| CD mixed | 8 (12.7%) | 4 (10.5%) | 4 (16.0%) |
| Thymoma | 10 (15.9%) | 5 (13.2%) | 5 (20.0%) |
| Follicular dendritic cell sarcoma | 3 (4.8%) | 3 (7.9%) | 0 (0.0%) |
| Types of skin lesions | |||
| Erythema multiforme-like | 24 (38.1%) | 13 (34.2%) | 11 (44.0%) |
| Pemphigoid-like | 27 (42.9%) | 17 (44.7%) | 10 (40.0%) |
| Lichen planus-like | 6 (9.5%) | 4 (10.5%) | 2 (8.0%) |
| Pemphigus-like | 5 (7.9%) | 3 (7.9%) | 2 (8.0%) |
| Graft-versus-host disease-like | 1 (1.6%) | 1 (2.6%) | 0 (0.0%) |
| PDAI | |||
| Moderate (< 15 scores) | 19 (30.2%) | 12 (31.6%) | 7 (28.0%) |
| Significant (15-45 scores) | 13 (20.6%) | 7 (18.4%) | 6 (24.0%) |
| Extensive (>45 scores) | 31 (49.2%) | 19 (50.0%) | 12 (48.0%) |
| Serological biomarkers | |||
| DSG1(+) | 19 (46.3%) [22] | 8 (36.4%) [16] | 11 (57.9%) [6] |
| DSG3 (+) | 8 (17.0%) [22] | 3 (13.6%) [16] | 5 (26.3%) [6] |
| Antibodies of myasthenia gravis (+) | 10 (29.4%) [29] | 5 (23.8%) [17] | 5 (38.5) [12] |
| BP180 (+) | 26 (81.3%) [31] | 15 (83.3%) [20] | 11 (78.6%) [11] |
| Clinical complications of PNP | |||
| Dyspnea | 38 (60.3%) | 20 (52.6%) | 14 (56.0%) |
| BO | 28 (44.4%) | 11 (28.9%) | 17 (68.0%) |
| Myasthenia gravis | 7 (11.1%) | 4 (10.5%) | 3 (12.0%) |
| Preoperative bacterial pulmonary infection | 8 (12.7%) | 2 (5.3%) | 6 (24.0%) |
| Preoperative fungal infection | 4 (6.3%) | 1 (2.6%) | 3 (12.0%) |
| Treatment of PNP | |||
| Corticosteroids | 60 (95.2%) | 35 (92.1%) | 25 (100.0%) |
| Immunosuppressive agents | 5 (7.9%) | 2 (5.3%) | 3 (12.0%) |
| Gammaglobulin | 30 (47.6%) | 16 (42.1%) | 14 (56.0%) |
| Perioperative data | |||
| Onset-to-surgical excision time/month, M(Q1, Q3) | 5 (3, 10) | 5 (3, 11) | 4 (3, 8) |
| Surgical time/h, M(Q1, Q3) | 3.7 (2.3, 5.2) | 3.1 (2.0, 5.0) | 4.0 (3.0, 5.6) |
| Intraoperative bleeding volume/mL, M(Q1, Q3) | 300 (100, 850) | 300 (100, 500) | 300 (150, 1350) |
| Laboratory findings at ICU admission, x±s | |||
| WBC/(×109/L) | 8.9±3.5 | 8.6±3.4 | 9.3±3.6 |
| PaCO2/mmHg | 45±10 | 45±9 | 46±13 |
| OI/mmHg | 227±100 | 256±112 | 183±55 |
| Albumin/(g/L) | 25.0±4.2 | 26.2±3.8 | 23.2±4.3 |
| Hgb /(g/L) | 98.1±16.9 | 101.7±14.9 | 92.4±18.5 |
| Worst score in ICU | |||
| APACHE Ⅱ, M(Q1, Q3) | 8 (6, 12) | 7 (4, 8) | 10 (6, 13) |
| SOFA, M(Q1, Q3) | 2 (2, 3) | 2 (1, 3) | 3 (2, 3) |
| Postoperative infection | |||
| High PCT | 26 (50.0%) [11] | 12 (38.7%) [7] | 14 (66.7%) [4] |
| Fungal infection | 15 (23.8%) | 4 (10.5%) | 11 (44.0%) |
| Outcomes | |||
| MVT/h, M(Q1, Q3) | 14 (4, 67) | 9 (4, 23) | 23 (12, 86) |
| ICU stay/d, M(Q1, Q3) | 3 (1, 4) | 3 (1, 4) | 3 (1, 19) |
| LHS/d, M(Q1, Q3) | 34 (14, 67) | 22 (14, 42) | 49 (25, 79) |
| Follow-up time/m, M(Q1, Q3) | 95 (75, 132) | 92 (74, 132) | 114 (81, 130) |
| In-hospital deaths | 9 (14.3%) | 9 (36.0%) | |
| Post-discharge deaths | 16 (25.4%) | 16 (64.0%) | |
| Survival times/month, M(Q1, Q3) | 34 (1, 143) | 42 (32, 70) | 5 (2, 25) |