血清胸腺活化调节趋化因子、CXC亚家族趋化因子13与弥漫大B细胞淋巴瘤患者化疗疗效和预后的关系研究  

Relationship between serum TARC and CXCL13 with chemotherapy efficacy and prognosis in patients with diffuse large B-cell lymphoma

作　　者：孙国锋[1] 索晓慧 刘洪峰[1] 贺冠强[1] 陈莉[1] 常伟 李俊东 毛丹 SUN Guofeng;SUO Xiaohui;LIU Hongfeng;HE Guanqiang;CHEN Li;CHANG Wei;LI Jundong;MAO Dan(Department of Hematology,Handan Central Hospital of Hebei Province,Handan,Hebei 056001,China)

机构地区：[1]河北省邯郸市中心医院血液内科,河北邯郸056001

出　　处：《检验医学与临床》2024年第21期3105-3110,共6页Laboratory Medicine and Clinic

基　　金：河北省重点研发计划项目卫生健康创新专项(21377752D)。

摘　　要：目的探讨血清胸腺活化调节趋化因子(TARC)、CXC亚家族趋化因子13(CXCL13)与弥漫大B细胞淋巴瘤(DLBCL)患者化疗疗效和预后的关系。方法选取2017年1月至2020年6月该院收治的285例DLBCL患者(DLBCL组)及同期健康体检者160例(对照组)作为研究对象,DLBCL患者接受利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松(R-CHOP)相关化疗方案,根据化疗效果分为有效组和无效组。比较DLBCL组与对照组、有效组与无效组血清TARC、CXCL13水平;随访统计DLBCL患者3年总生存期(OS)及无进展生存期(PFS),采用Logistic回归分析DLBCL患者预后及疾病进展的影响因素,并构建回归预测模型,采用受试者工作特征(ROC)曲线分析其预测评估效能。采用Kaplan-Meier生存曲线分析不同水平血清TARC、CXCL13与DLBCL患者3年OS及PFS的关系。结果DLBCL组治疗前血清TARC、CXCL13水平高于对照组(P<0.05)。DLBCL患者化疗有效率为85.26%,无效组治疗前血清TARC、CXCL13水平高于有效组(P<0.05)。多因素Logistic分析结果显示,Ann Arbor分期Ⅲ/Ⅳ期、TARC高表达及CXCL13高表达均是DLBCL患者预后的独立危险因素(P<0.05)。乳酸脱氢酶水平升高、TARC高表达及CXCL13高表达均是DLBCL患者疾病进展的独立危险因素(P<0.05)。以上述影响因素构建回归预测模型,ROC曲线分析显示,预测模型预测预后的曲线下面积(AUC)为0.874,预测疾病进展的AUC为0.911。TARC低表达患者的3年OS、PFS优于高表达患者(P<0.05),CXCL13低表达患者的3年OS、PFS优于高表达患者(P<0.05)。结论DLBCL患者血清TARC、CXCL13水平异常升高,血清TARC、CXCL13低表达的DLBCL患者具有更好的化疗效果及预后。包括血清TARC、CXCL13在内的多因子预测模型对DLBCL患者预后具有较高的评估效能。Objective To investigate the relationship between serum thymus activation-regulated chemokine(TARC)and CXC subfamily chemokine 13(CXCL13)with the chemotherapy efficacy and prognosis in patients with diffuse large B-cell lymphoma(DLBCL).Methods A total of 285 patients with DLBCL(DLBCL group)admitted to the hospital from January 2017 to June 2020,meanwhile 160 healthy individuals(control group)were selected.DLBCL patients received chemotherapy with a regimen of rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone(R-CHOP).The patients were divided into effective group and ineffective group according to the chemotherapy efficacy.Serum levels of TARC and CXCL13 were compared between the DLBCL group and control group,as well as between the effective group and ineffective group.The overall survival(OS)and progression-free survival(PFS)of DLBCL patients were recorded over a 3-year follow-up period.Logistic regression was used to analyze the factors influencing prognosis and disease progression in DLBCL patients,and a regression prediction model was constructed.The predictive performance was assessed using receiver operating characteristic(ROC)curve.Kaplan-Meier survival analysis was plotted to evaluate the relationship between serum TARC,CXCL13 levels and the 3-year OS,PFS of DLBCL patients.Results The pre-treatment serum TARC and CXCL13 levels in the DLBCL group were higher than those in the control group(P<0.05).The effective rate of chemotherapy in DLBCL patients was 85.26%,and the pre-treatment serum TARC and CXCL13 levels in the ineffective group were higher than those in the effective group(P<0.05).The results of multivariate Logistic analysis showed that Ann Arbor stageⅢ/Ⅳ,high TARC expression and high CXCL13 expression were independent risk factors affecting the prognosis of DLBCL patients(P<0.05).Elevated lactate dehydrogenase,high TARC expression and high CXCL13 expression were all independent risk factors affecting disease progression in DLBCL patients(P<0.05).A regression prediction model was

关 键 词：弥漫大B细胞淋巴瘤 胸腺活化调节趋化因子 CXC亚家族趋化因子13 化疗疗效 预后 

分 类 号：R733.1[医药卫生—肿瘤] R446.6[医药卫生—临床医学]