肺粘液真菌症:治療法および基礎疾患別の転帰
Chelsea Powell1, Carlos A Puig2, Sahar A Saddoughi2
1Department of Surgery, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
The Annals of thoracic surgery
|February 27, 2026
まとめ
肺粘液真菌症の外科的切除は生存率を改善する。しかし、基礎にある血液悪性腫瘍は、治療にもかかわらず長期予後不良と関連している。
科学分野:
- 呼吸器科
- 感染症
- 腫瘍外科
背景:
- 肺粘液真菌症は、まれで重篤な日和見真菌感染症です。
- 主に基礎疾患を持つ免疫不全個人に影響します。
研究 の 目的:
- 外科的介入選択に影響を与える要因を特定する。
- 院内死亡率および全生存期間(OS)の予測因子を決定する。
主な方法:
- 単一施設における86人の肺粘液真菌症患者(2000-2021年)のレビュー。
- 退院状況についてはロジスティック回帰分析、OSについてはログランク検定を実施。
- 外科的介入、死亡率、生存率データの分析。
主要な成果:
- 院内死亡率は46.5%でした。
- 抗真菌薬と組み合わせた外科的切除は、退院時の生存率を改善しました(73.2% vs 35.6%)。
- 血液悪性腫瘍は、固形臓器移植レシピエントと比較してOSが低いことと相関していました。
結論:
- 外科的切除は、選択された肺粘液真菌症患者の生存率を向上させます。
- 両側性または肺外性疾患であっても手術を検討してください。
- 血液悪性腫瘍は長期生存率不良の前兆となります。
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