骨髓增生异常综合征血清TIM-3、IL-10的表达及其与病情程度及临床预后的关系  

Expression of serum TIM-3 and IL-10 in myelodysplastic syndrome and their relationship with severity of disease and clinical prognosis

作　　者：范青 满其航 王玉 FAN Qing;MAN Qihang;WANG Yu(Department of Hematology,Beijing Shunyi Hospital,Beijing,101300,China;Department of Hematology,Beijing Aerospace Center Hospital;Department of Hematology and Oncology,Beijing Aerospace General Hospital)

机构地区：[1]北京市顺义区医院血液内科,北京101300 [2]北京航天中心医院血液科 [3]北京航天总医院血液肿瘤科

出　　处：《临床血液学杂志》2023年第8期577-583,共7页Journal of Clinical Hematology

摘　　要：目的分析血清T细胞免疫球蛋白黏液素3(T cell immnoglobulin and mucin 3,TIM-3)、白细胞介素-10(interleukin,IL-10)在骨髓增生异常综合征(myelodysplastic syndrome,MDS)患者中表达,并验证2项指标与患者病情程度及临床预后的关系。方法回顾性分析2016年7月-2021年7月收治的100例MDS患者临床资料。根据患者病情程度[参照骨髓增生异常综合征国际预后评分系统(IPSS)、WHO的预后积分系统(WPSS)、修订的IPSS(IPSS-R)评定]分为相对低危组和相对高危组。同时查阅及统计患者基线资料、血清TIM-3、IL-10水平。比较2组患者血清TIM-3、IL-10水平。根据IPSS、WPSS及IPSS-R分期对治疗前血清TIM-3、IL-10水平绘制受试者工作特征曲线图分析,根据最佳截断值分为TIM-3与IL-10高表达组和低表达组;比较不同血清TIM-3、IL-10表达情况的MDS患者基线资料及IPSS、WPSS及IPSS-R评分情况。同时查阅患者随访1年(截至2022年7月)的结果,比较不同TIM-3、IL-10表达情况的MDS患者生存情况。结果100例患者中相对低危组38例,相对高危组62例;相对高危组血清TIM-3、IL-10水平均高于相对低危组(P<0.05)。按TIM-3为1.680 ng/mL分组,TIM-3高表达组50例,TIM-3低表达组50例;按IL-10为119.075 pg/mL分组,IL-10高表达组54例,IL-10低表达组46例。不同血清TIM-3、IL-10水平患者性别、年龄、FAB分型情况及治疗前白细胞、血小板、血红蛋白水平比较,差异无统计学意义(P>0.05)。TIM-3高表达组IPSS、WPSS及IPSS-R评分高危占比均高于TIM-3低表达组,IL-10高表达组IPSS、WPSS及IPSS-R评分高危占比均高于IL-10低表达组(P<0.05)。血清TIM-3高表达的MDS患者1年生存时间(10.68±0.42)个月,明显低于低表达患者(11.94±0.04)个月(χ^(2)=5.192,P=0.023)。IL-10高表达的MDS患者1年生存时间(10.89±0.37)个月,明显低于低表达患者(11.80±0.17)个月(χ^(2)=3.888,P=0.049)。结论血清TIM-3、IL-10在MDS患者中表达存在一定的差异性,其Objective To analyze the expression of serum T-cell immunoglobulin mucin 3(TIM-3)and interleukin-10(IL-10)in the patients with myelodysplastic syndrome(MDS),and verify the relationship between the two indexes and the severity of the disease and clinical prognosis.Methods The clinical data of 100 MDS patients admitted to the hospital from July 2016 to July 2021 were analyzed retrospectively.The patients were divided into relatively low risk group and relatively high risk group according to the degree of illness(with reference to the International Prognosis Scoring System[IPSS]for myelodysplastic syndromes,the WHO Prognosis Scoring System[WPSS],and the revised IPSS-R evaluation).At the same time,the baseline data,serum TIM-3 and IL-10 levels of patients were reviewed and counted.The serum TIM-3 and IL-10 levels were compared between the two groups.According to IPSS,WPSS and IPSS-R stages,the levels of TIM-3 and IL-10 in serum before treatment were analyzed by receiver operating characteristic curve.According to the best cut-off value,TIM-3 and IL-10 were divided into high expression group and low expression group.The baseline data and IPSS,WPSS and IPSS-R scores of MDS patients with different serum TIM-3 and IL-10 expressions were compared.At the same time,the patients were followed up for 1 year(the end time was July 2022),and the survival of MDS patients with different expressions of TIM-3 and IL-10 were compared.Results Among the 100 patients,38 were in the relatively low-risk group and 62 in the relatively high-risk group.The serum TIM-3 and IL-10 levels in the relatively high-risk group were higher than those in the relatively low-risk group(P<0.05).According to the TIM-3 ratio of 1.680 ng/mL,50 patients were in the TIM-3 high expression group and 50 patients in the TIM-3 low expression group.According to the IL-10 level of 119.075 pg/mL,54 cases were in the IL-10 overexpression group and 46 cases were in the IL-10 low expression group.There was no statistical significant difference in sex,age,FAB classificati

关 键 词：骨髓增生异常综合征 T细胞免疫球蛋白黏液素3 白细胞介素-10 病情程度 生存时间 

分 类 号：R551.3[医药卫生—血液循环系统疾病]