IL-2R、IL-6、IL-8、TNF-α在弥漫性大B细胞淋巴瘤中的变化及其意义  

Variation and significance of IL-2R,IL-6,IL-8 and TNF-αin diffuse large B-cell lymphoma

作　　者：包维莺[1,3] 施晴 霍雨佳 易红梅 董磊[2] 王黎[1] 程澍[1] 许彭鹏[1] 赵维莅[1] BAO Weiying;SHI Qing;HUO Yujia;YI Hongmei;DONG Lei;WANG Li;CHENG Shu;XU Pengpeng;ZHAO Weili(Department of Hematology,RuiJin Hospital,Shanghai Jiao Tong University School of Medicine,State Key Laboratory of Medical Genomics,Shanghai Institute of Hematology,Shanghai,200025,China;Department of Pathology,RuiJin Hospital,Shanghai Jiao Tong University School of Medicine)

机构地区：[1]上海交通大学医学院附属瑞金医院血液科,医学基因组学国家重点实验室,上海血液学研究所,上海200025 [2]上海交通大学医学院附属瑞金医院病理科 [3]上海交通大学医学院附属松江医院(筹)血液科,上海201699

出　　处：《临床血液学杂志》2023年第1期33-38,共6页Journal of Clinical Hematology

摘　　要：目的:探究细胞因子IL-2R、IL-6、IL-8、TNF-α在弥漫性大B细胞淋巴瘤(DLBCL)中的变化及其意义。方法:收集上海交通大学医学院附属瑞金医院收治的155例R-CHOP(利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松)方案治疗后达完全缓解且无进展生存期≥24个月的DLBCL患者(持续缓解组)和45例R-CHOP方案治疗后达完全缓解但是在2年内复发的DLBCL患者(复发组)。持续缓解组患者于治疗前、第6个周期治疗开始前以及持续缓解治疗结束1年后采血,复发组患者于治疗前、第6个周期治疗开始前及复发时间点采血。采用IMMUNITE 1000化学发光分析仪检测细胞因子IL-2R、IL-6、IL-8、TNF-α的含量。结果:IL-2R、IL-6及TNF-α含量在Ⅲ~Ⅳ期、ECOG评分≥2分、结外受累个数≥2个、IPI评分≥3分的DLBCL患者中显著升高(P<0.05);IL-8在IPI评分≥3分和双表达淋巴瘤(DEL)的患者中显著升高(P<0.05);IL-6在non-GCB亚型中显著升高(P<0.05)。复发组患者治疗前血清细胞因子IL-2R、IL-6、TNF-α含量均较持续缓解组显著升高(P<0.05)。治疗6个周期开始前同治疗前比较,复发组和持续缓解组IL-2R、IL-6、IL-8、TNF-α含量均显著降低(P<0.05),以上指标在持续缓解组持续降低,而复发组在复发时又显著升高(P<0.05)。IL-2R含量≥1398 U/mL(P<0.001)、IL-6含量≥7.1 pg/mL(P=0.004)、TNF-α含量≥19.5 pg/mL(P<0.001)与短的总生存期显著相关。结论:治疗前复发组和持续缓解组患者IL-2R、IL-6、IL-8、TNF-α含量存在明显差异,且以上指标在缓解时降低,复发时再次升高,或许可成为预测和评估DLBCL患者R-CHOP治疗后复发的有效血清标记分子。此外,治疗前血清中高的IL-2R、IL-6及TNF-α与DLBCL患者不良预后相关。Objective:To investigate the variation and significance of IL-2 R,IL-6,IL-8 and TNF-α levels in diffuse large B-cell lymphoma(DLBCL).Methods:A total of 155 cases of DLBCL with complete remission and progression free survival ≥ 24 months after R-CHOP treatment(continuous remission group) and 45 cases of relapsed DLBCL within 2 years after R-CHOP treatment(relapse group) were collected from Rui Jin Hospital,Shanghai Jiao Tong University School of Medicine.Blood samples were collected from patients of the continuous remission group at 3 time points,before treatment,before the start of the 6 th cycle of treatment and one year after the end of continuous remission.Patients in the relapse group were sampled before treatment,before the start of the 6 th cycle of treatment and at the time of relapse.The contents of inflammatory cytokines IL-2 R,IL-6,IL-8 and TNF-α were detected by IMMUNITE 1000 chemiluminescence analyzer.Results:The levels of IL-2 R,IL-6 and TNF-α were significantly increased in DLBCL patients with Ann Arbor stage of Ⅲ-Ⅳ,ECOG score≥2,number of extranodal involvement≥2,IPI score≥3(P<0.05),while IL-8 level was significantly increased in patients with IPI score≥3 and DEL(P<0.05) and IL-6 was significantly increased in non-GCB subtype(P<0.05).The levels of serum cytokines IL-2 R,IL-6 and TNF-α in the relapse group were significantly higher than those of the continuous remission group before treatment(P<0.05).Compared with those before treatment,IL-2 R,IL-6,IL-8 and TNF-α levels in the relapse group and the continuous remission group were significantly decreased before the start of the 6 th cycle of treatment(P<0.05),and the levels of the above cytokines continued to decreased in the continuous remission group while increased in the relapse group(P<0.05).IL-2 R content≥1398 U/mL(P<0.001),IL-6 content ≥7.1 pg/mL(P=0.004),TNF-α content ≥19.5 pg/mL(P<0.001) were significantly associated with shorter overall survival.Conclusion:The levels of IL-2 R,IL-6,IL-8 and TNF-α were significantly

关 键 词：弥漫性大B细胞淋巴瘤 持续缓解 复发 IL-2R IL-6 IL-8 TNF-Α 

分 类 号：R733.4[医药卫生—肿瘤]