摘要
目的:探讨细胞因子在初诊弥漫大B细胞淋巴瘤(DLBCL)患者中的表达及预后价值。方法:收集2017年6月至2018年11月在云南省第一人民医院确诊为DLBCL的62名患者的临床资料,回顾性分析14种血清细胞因子[(白介素(IL)-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-12p70、IL-17A、IL-17F、IL-22、干扰素(IFN)-γ、肿瘤坏死因子(TNF)-α、TNF-β]的表达水平在不同生存结局患者中的差异,及其对DLBCL患者3年无进展生存期(PFS)和3年总生存期(OS)的影响。结果:14种细胞因子中,仅IL-10在不同生存结局患者中的表达差异具有统计学意义(P=0.007)。根据受试者工作特征(ROC)曲线,IL-10的最佳cut-off值为11.74 pg/ml。初诊DLBCL患者血清IL-10与感染指标降钙素原(PCT)(r=0.321,P=0.029)、C-反应蛋白(CRP)(r=0.320,P=0.013)及肿瘤负荷指标乳酸脱氢酶(LDH)(r=0.439,P<0.001)呈正相关。初诊时存在肺部感染的患者IL-10水平较无肺部感染患者明显升高(P=0.012),但是,是否存在肺部感染对3年生存结局的影响未发现有统计学意义。IL-10水平在不同分期患者中无显著差异(P>0.05)。高IL-10水平(IL-10>11.74 pg/ml)组患者的LDH水平显著高于低IL-10水平(IL-10≤11.74 pg/ml)组(P<0.001)。高IL-10水平组DLBCL患者的3年PFS率和3年OS率较低IL-10水平组显著降低[(44.4±11.7)%vs(81.8±5.8)%,P<0.001;(61.6±11.5)%vs(93.2±3.8)%,P=0.001]。结论:初诊DLBCL患者血清IL-10水平可以反映机体炎症状态,可能与肿瘤负荷相关。初诊时血清IL-10>11.74 pg/ml的DLBCL患者早期死亡率较高,预后更差。
Objective:To investigate the expression and prognostic value of cytokines in patients with newly diagnosed diffuse large B-cell lymphoma(DLBCL).Methods:Clinical data of 62 patients diagnosed with DLBCL in the First People's Hospital of Yunnan Province from June 2017 to November 2018 were collected.The differences in expression levels of 14 serum cytokines[interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,interferon(IFN)-γ,tumor necrosis factor(TNF)-α,TNF-β]in patients with different survival outcomes,and the impact of the cytokines on 3-year progression-free survival(PFS)and 3-year overall survival(OS)of patients with DLBCL were analyzed retrospectively.Results:Among the 14 cytokines,only the expression of IL-10 was significantly different in patients with different survival outcomes(P=0.007).According to the receiver operating characteristic(ROC)curve,the optimal cut-off value for IL-10 was 11.74 pg/ml.Serum IL-10 was positively correlated with infection markers procalcitonin(PCT)(r=0.321,P=0.029),C-reactive protein(CRP)(r=0.320,P=0.013)and tumor burden index lactate dehydrogenase(LDH)(r=0.439,P<0.001)in newly diagnosed DLBCL patients.The level of IL-10 in patients with pulmonary infection was significantly higher than that in patients without pulmonary infection(P=0.012).However,there was no statistically significant difference on the 3-year survival outcomes between patients with or without pulmonary infection.There was no significant difference in IL-10 level in patients with different Ann Arbor stages(P>0.05).Patients with high IL-10 level(IL-10>11.74 pg/ml)had significantly higher LDH level than those with low IL-10 level(IL-10≤11.74 pg/ml)(P<0.001).The 3-year PFS rate and 3-year OS rate of DLBCL patients with high IL-10 level were significantly lower than those of low IL-10 level group[(44.4±11.7)%vs(81.8±5.8)%,P<0.001;(61.6±11.5)%vs(93.2±3.8)%,P=0.001].Conclusion:Serum IL-10 level in newly diagnosed DLBCL patients can reflect the inflammatory state of the body,which may be related to tumor load.Newly diagnosed DLBCL patients with serum IL-10>11.74 pg/ml have higher early mortality and worse prognosis.
作者
满艳
葛传琴
李增政
杨同华
王娅婕
MAN Yan;GE Chuan-Qin;LI Zeng-Zheng;YANG Tong-Hua;WANG Ya-Jie(Department of Hematology,The Affiliated Hospital of Kunming University of Science and Technology,The First People's Hospital of Yunnan Province,Kunming 650500,Yunnan Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2023年第4期1050-1055,共6页
Journal of Experimental Hematology
基金
国家自然科学基金(82070173,82060810)
云南省应用基础研究项目(202101AW070017)
云南省临床医学中心开放课题(2020LCZXKF-XY14)。
