恶性淋巴增殖性疾病患者血清可溶性细胞间粘附分子-1的检测

Serum levels of soluble intercellular adhesion molecule 1 in malignant lymphoproliferative disorders

目的观察恶性淋巴细胞增殖性疾病患者血清可溶性细胞间粘附分子１（ｓＩＣＡＭ１）水平的变化及其与病情、疗效的关系。方法采用亲合素和生物素标记的酶联免疫法，对多发性骨髓瘤（ＭＭ）、恶性淋巴瘤（ＭＬ）及急性淋巴细胞白血病（ＡＬＬ）患者化疗前后血清ｓＩＣＡＭ１水平进行检测。结果２２例ＭＭ患者中９例（４１％）、３２例非霍奇金淋巴瘤（ＮＨＬ）患者中１７例（５３％）、１９例ＡＬＬ患者中１２例（６３％）的血清ｓＩＣＡＭ１水平高于正常。血清ｓＩＣＡＭ１水平，ＭＭ患者中受Ｃ反应蛋白和β２微球蛋白为依据的Ｂａｔａｉｌｅ分期的影响，与Ｄｕｒｉｅ分期无关；ＮＨＬ患者中，与病理类型、ＡｎｎＡｒｂｏｒ分期、Ｂ症状有关，与血清乳酸脱氢酶无关；ＡＬＬ患者中，合并中枢神经系统白血病者明显高于未合并者。血清ｓＩＣＡＭ１升高者与血清ｓＩＣＡＭ１正常者比较，前者疗效较差。动态观察发现，随着病情缓解，血清ｓＩＣＡＭ１水平亦降至正常。结论血清ｓＩＣＡＭ１水平的检测有助于判断患者的病情及疗效。

Objective To investigate the correlation of serum levels of soluble intercellular adhesion molecule 1 (sICAM1) with clinical situation and treatment outcome in lymphoproliferative disorders. Methods Serum sICAM1 levels were measured by immunoenzymetic assay. Results Pretreatment serum sICAM1 levels were above normal in 41% (9/22) of multiple myeloma (MM), 53% (17/32) of nonHodgkins lymphoma (NHL) and 63% (12/19) of acute lymphocytic leukemia (ALL) patients. Serum sICAM1 levels in MM were positively correlated with Bataille stages, but were not related to Durie stage. Meanwhile, sICAM1 levels in NHL were associated with the category of pathology, Ann Arbor stage and B symptom, but were not related to serum LDH levels. sICAM1 levels were significantly higher in ALL patients complicated with central nervous system leukemia (CNSL) than in those without CNSL. Patients with elevated serum sICAM1 levels had poorer treatment outcomes. Serum sICAM1 levels were returned to normal at remission. WTHZ]Conclusion Measurement of serum sICAM1 levels in lymphoproliferative disorders patients is helpfull for judging the clinical status and treatment outcome.