血清IL-10、TGF-β_(1)、sCD30联检对非霍奇金淋巴瘤患者化疗相关间质性肺炎的预测价值  

Predictive value of combined detection of serum IL-10,TGF-β_1,and sCD30 for chemotherapy-related interstitial pneumonia in patients with non-Hodgkin lymphoma

作　　者：王建新 姬玉涵 刘宁洒 姚金晓 WANG Jian-xin;JI Yu-han;LIU Ning-sa;YAO Jin-xiao(Department of Blood Lymphoma,Nanyang Second People's Hospital,Nanyang 473000,Henan,CHINA)

机构地区：[1]南阳市第二人民医院血液淋巴瘤科,河南南阳473000

出　　处：《海南医学》2024年第5期699-703,共5页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20202162)。

摘　　要：目的 探究血清白细胞介素-10 (IL-10)、转化生长因子-β_(1)(TGF-β_(1))、可溶性CD30 (sCD30)联检对非霍奇金淋巴瘤(NHL)患者化疗相关间质性肺炎(IP)的预测价值。方法 回顾性分析2019年1月至2022年12月南阳市第二人民医院收治的168例NHL患者的临床诊治资料,根据化疗期间是否出现IP分为IP组(n=37)和非IP组(n=131),比较两组患者的一般资料、入院时血清IL-10、TGF-β_(1)、sCD30水平,采用Logistic回归方程筛选IP发生影响因素,绘制受试者工作特征曲线(ROC)及曲线下面积(AUC)分析血清IL-10、TGF-β_(1)、sCD30预测IP效能,采用相对危险度(RR)分析不同血清IL-10、TGF-β_(1)、sCD30表达对IP发生的影响。结果 IP组患者的血清LDH水平为(288.84±86.41) U/L,利妥昔单抗应用所占比例为48.65%,明显高于非IP组的(199.95±59.66) U/L、22.90%,差异均有统计学意义(P<0.05),但两组患者的性别、年龄、BMI、IPI评分、临床分期、全身症状、肺实质侵犯、骨髓侵犯、以往基础肺疾病史、吸烟史比较差异均无统计学意义(P>0.05);IP组患者的血清IL-10、TGF-β_(1)、sCD30水平分别为(25.41±7.60) ng/L、(29.55±8.83) pg/mL、(142.21±42.67) k U/L、,明显高于非IP组的(18.00±5.41) ng/L、(20.65±6.20) pg/mL、(98.87±28.96) kU/L、,差异均有统计学意义(P<0.05);经Logistic回归方程显示,IL-10 (OR:18.046)、TGF-β_(1)(OR:16.755)、sCD30 (OR:17.126)、LDH (OR:15.561)、应用利妥昔单抗(OR:10.331)均是NHL患者化疗相关IP发生的影响因素(P<0.05);经ROC分析结果显示,血清IL-10、TGF-β_(1)、sCD30联合预测IP效能[AUC:0.947,95%CI:0.901~0.976]明显优于三者单一预测[AUC:0.740,95%CI:0.667~0.804]、[AUC:0.762,95%CI:0.691~0.824]、[AUC:0.745,95%CI:0.672~0.809];血清IL-10、TGF-β_(1)、sCD30高表达者IP发生率是低表达的2.914、5.287、3.142倍。结论 血清IL-10、TGF-β_(1)、sCD30是NHL患者化疗相关IP的高危因素,联合检测有助于提高预测效能,指导临床医生做Objective To explore the predictive value of combined detection of serum interleukin-10 (IL-10),transforming growth factor-β_1(TGF-β_1),and soluble CD30 (sCD30) in predicting chemotherapy-related interstitial pneumonia (IP) in patients with non-Hodgkin lymphoma (NHL).Methods The clinical diagnosis and treatment data of 168NHL patients admitted to the Nanyang Second People's Hospital from January 2019 to December 2022 were retrospectively analyzed and classified into the IP group (n=37) and the non-IP group (n=131) according to the presence or absence of IP during chemotherapy.The general data,serum IL-10,TGF-β_1,and sCD30 levels at admission were compared between the two groups.Logistic regression equations were used to screen the factors affecting the occurrence of IP.The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive efficacy of serum IL-10,TGF-β_1,and sCD30 for IP.The relative risk (RR) was used to analyze the influence of different serum IL-10,TGF-β_1,and sCD30 expressions on the occurrence of IP.Results The serum LDH level in the IP group was (288.84±86.41) U/L,and the proportion of rituximab application was 48.65%,which were significantly higher than (199.95±59.66) U/L and 22.90%in the non-IP group (P<0.05).However,there were no significant differences in gender,age,BMI,IPI score,clinical stage,systemic symptoms,lung parenchyma invasion,bone marrow invasion,previous history of underlying lung disease,and smoking history between the two groups (P>0.05).The serum IL-10,TGF-β_1,and sCD30 levels in the IP group were (25.41±7.60) ng/L,(29.55±8.83) pg/mL,and (142.21±42.67) kU/L,respectively,which were significantly higher than (18.00±5.41) ng/L,(20.65±6.20) pg/mL,and (98.87±28.96) kU/L in the non-IP group (P<0.05).Logistic regression equation showed that IL-10 (OR:18.046),TGF-β_1(OR:16.755),sCD30 (OR:17.126),LDH (OR:15.561),and the use of rituximab (OR:10.331) were all influencing factors for the occurrence of chemotherapy-related IP

关 键 词：非霍奇金淋巴瘤 化疗 间质性肺炎 白细胞介素-10 转化生长因子-β_(1) 可溶性CD30 

分 类 号：R733.4[医药卫生—肿瘤]