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  • 刁建军,刘倚含,李 冰,等.炎性指标在弥漫大B细胞淋巴瘤患者中的临床意义[J].同济大学学报(医学版),2019,30(3):309-314.    [点击复制]
  • DIAO Jian-jun,LIU Yi-han,LI Bing,et al.Clinical significance of inflammatory indexes in patients with diffuse large B-cell lymphoma[J].同济大学学报(医学版),2019,30(3):309-314.   [点击复制]
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炎性指标在弥漫大B细胞淋巴瘤患者中的临床意义
刁建军,刘倚含,李冰,曾郁,梁爱斌,修冰
0
(同济大学附属同济医院血液科,上海 200065;上海市浦东医院急诊科,上海 201399)
摘要:
目的 探讨炎性指标在初发弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL)中的临床意义。方法 收集同济大学附属同济医院2015—2017年初诊的40例DLBCL患者的临床资料,检测患者治疗前血清炎性指标TNF-α、可溶性白细胞介素2受体(soluble interleukin 2 receptor, sIL-2r)、IL-6及IL-8、C反应蛋白(C-reactive protein, CRP)和铁蛋白、血β2微球蛋白(beta2-microglobulin, β2-MG)、乳酸脱氢酶(lactate dehydrogenase, LDH)水平,对比不同分组患者上述指标的差别。结果 初治未达完全缓解组患者炎性指标CRP和IL-8较完全缓解组显著增高;在合并B组症状患者中,炎性指标sIL-2r、IL-6、TNF-α和CRP均有显著增高,血β2-MG、LDH、铁蛋白也明显高于无B组症状患者;高国际预后指数(international prognostic index, IPI)患者中,炎性指标sIL-2r、IL-6、CRP和肿瘤负荷指标血β2-MG、铁蛋白、LDH均明显增高。炎性指标与肿瘤负荷指标存在显著相关性。结论 患者合并B组症状,体内IPI分期越高,肿瘤负荷越高,炎性指标越高,炎症反应越激烈。炎性因子可作为IPI的补充,成为预测患者预后分层和选择治疗方案的潜在指标。
关键词:  弥漫大B细胞淋巴瘤  可溶性白细胞介素2受体  白细胞介素6  国际预后指数
DOI:10.16118/j.1008-0392.2019.03.009
投稿时间:2018-09-17
基金项目:国家自然科学基金青年项目(81600156);上海市卫生和计划生育委员会科研课题青年项目(20174Y0110);上海申康医院发展中心新兴前沿技术项目(SHDC12015108);同济大学“中央高校基本科研业务费专项资金”(22120170004)
Clinical significance of inflammatory indexes in patients with diffuse large B-cell lymphoma
DIAO Jian-jun,LIU Yi-han,LI Bing,ZENG Yu,LIANG Ai-bin,XIU Bing
(Dept. of Hematology, Tongji Hospital,Tongji University, Shanghai 200065, China; Dept. of Emergency, Shanghai Pudong Hospital, Shanghai 201399, China)
Abstract:
Objective To investigate the clinical significance of inflammatory indexes in patients with primary diffuse large B-cell lymphoma (DLBCL). Methods The clinical data of 40 patients with DLBCL admitted in Tongji Hospital, Tongji University from 2015 to 2017 were retrospectively analyzed. The serum levels of TNF-α, soluble interleukin 2 receptor (sIL-2r), IL-6, IL-8, C-reactive protein (CRP) , ferritin, beta 2-microglobulin (β2-MG), lactate dehydrogenase (LDH) were detected before treatment and compared among different groups. Results CRP and IL-8 were significantly increased in patients without complete remission after initial treatment. The sIL-2r, IL-6, TNF-α, CRP, serum β2-MG, LDH and ferritin were significantly higher in patients with group B symptoms than those without group B symptom. The IL-6, CRP and tumor load index, serum β2-MG, ferritin and LDH all increased significantly in patients with high international prognostic index (IPI). Inflammatory indexes were significantly correlated with tumor burden indexes. Conclusion Patients with higher IPI stage have heavier tumor burden; patients with group B symptoms have higher levels of inflammatory cytokines and CRP, indicating the existence of more intense inflammatory reaction. Inflammatory indexes can be used as a supplement to IPI and as a potential predictor of prognostic stratification and treatment options.
Key words:  diffuse large B-cell lymphoma  soluble interleukin-2 receptor  interleukin-6  intern-ational prognostic index

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