B细胞恶性肿瘤患者外周血浆B细胞刺激因子水平测定及临床意义

Measurement and clinical significance of B lymphocyte stimulators level in peripheral blood plasma from patients with B cell malignancies

目的研究B细胞恶性肿瘤(多发性骨髓瘤、B细胞非何杰金淋巴瘤)患者外周血浆B细胞刺激因子(Blys)水平,探讨Blys的血浆水平与多发性骨髓瘤(MM)、B细胞非何杰金淋巴瘤(B-NHL)的关系,分析Blys在MM、B-NHL发病中的作用。方法应用酶联免疫吸附法(ELISA)检测MM(12例)、B-NHL(31例)患者外周血浆Blys水平,以健康献血员(30例)作为对照,并对B-NHL不同分型及化疗前、后患者血浆Blys水平进行比较。结果MM、Ⅰ～Ⅱ期和Ⅲ一Ⅳ期B-NHL化疗前血浆Blys水平显著高于正常对照组(P<0.01);Ⅰ～Ⅱ期、Ⅲ～Ⅳ期B-NHL化疗前均显著高于化疗后(P<0.01),Ⅲ～Ⅳ期B-NHL化疗前显著高于Ⅰ～Ⅱ期(P<0.05)。且B-NHL的不同组织类型化疗前血浆BlyS水平各不相同,均显著高于正常对照组(P<0.01),且显著高于化疗后(P<0.01);其中弥漫性大B细胞淋巴瘤显著高于B-慢性淋巴细胞白血病/小细胞淋巴瘤、套细胞淋巴瘤(P<0.01)。结论外周血浆Blys水平在MM、B-NHL患者外周血中明显升高,且在B-NHL中与组织类型、分期和治疗有关,提示Blys可能参与B细胞恶性肿瘤发病过程,有望成为B细胞恶性肿瘤诊断、判断分期和评价疗效的新指标。

Objective To determine the level of B lymphocyte stimulators （Blys） in peripheral blood plasma from patients with B cell malignancies （multiple myeloma; B-cell non-Hodgkin lymphoma）, and investigate the relationship between the level of Blys in plasma and B cell malignancies （MM, B-NHL）. Methods The level of Blys in plasma from patients with MM（n=12） and B-NHL （n=31） and healthy volunteers （n=30） were measured respectively with enzyme-linked immunosorbent assay（ELISA）. Moreover the level of Blys was compared not only in different phenotypes of B-NHL but also between before and after chemotherapy. Results The level of Blys in plasma with MM, stage Ⅰ- Ⅱ and stage Ⅲ-Ⅳ B-NHL are higer than those of healthy controls （P〈0.01）; those before chemotherapy are higer than after chemotherapy in stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ B-NHL （P〈0.01）, those in stage Ⅲ-Ⅳ are higer than in stage Ⅰ-Ⅱ before chemotherapy （P〈0.05）. The diffuse large cell lymphoma （DLCL） is higher than small lymphocytic lymphoma （B-CLL/SLL） mantle cell lymphoma （MCL）（P〈0.01）. Conclusions The level of Blys in plasma from patients with MM and B-NHL axe significantly elevated, which correlate with histologic subtypes, different stage and therapy which suggests Blys might be involved in the pathogenesis of B cell malignancies, measurement of Blys might be a new item for the diagonosis, staging of B cell malignancies and evaluation of therapy.