皮肤T细胞性淋巴瘤患者血清sIL-2R和TNF_α及其sTNF-R Ⅰ的检测与临床意义

Measurement of Serum Concentration of sIL2R,TNFα and sTNFR Ⅰ in Cutaneous T-Cell Lymphoma and It's Clinical Significance

目的探讨可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）、肿瘤坏死因子α（ＴＮＦα）及其可溶性受体Ⅰ型（ｓＴＮＦ－ＲⅠ）在皮肤Ｔ细胞性淋巴瘤（ＣＴＣＬ）发病机制中的作用。方法采用单克隆和多克隆双抗体夹心法，测定ＣＴＣＬ患者和对照组血清标本中ｓＩＬ－２Ｒ、ＴＮＦα和ｓＴＮＦ－ＲⅠ，同时测定血清乳酸脱氢酶（ＬＤＨ）水平。结果ＣＴＣＬ患者血清ｓＩＬ－２Ｒ水平明显高于对照组（Ｐ＜０．０１），同时ｓＩＬ－２Ｒ增高的比例在不同的临床分期中也不同，其中，血清中ｓＩＬ－２Ｒ在Ⅳ期病人中明显高于Ⅰ、Ⅱ期（Ｐ＜０．０５）。治疗有效时，ｓＩＬ－２Ｒ水平下降。ｓＩＬ－２Ｒ水平与血ＬＤＨ无相关性。ＴＮＦα水平明显高于正常对照组（Ｐ＜０．０１），ｓＴＮＦ－ＲⅠ除个别升高外，大部分在正常范围内，且与分期无相关（Ｐ＞０．０５）。结论测定血清ｓＩＬ－２Ｒ可作为ＣＴＣＬ患者病情判断、疗效观察及估计预后的生物学指标。而ＴＮＦ的升高，表明细胞因子参与了肿瘤的发生和发展。

Purpose To study the clinical significance of soluble interleukin-2 receptor (sTNF2R),tumor necrosis factor alpha (TNFα) and soluble tumor necrosis factor receptor I (sTNFRⅠ) in the mechanism of the development of cutaneous T cell lymphoma (CTCL). Methods The level of sIL2R,TNF α,sTNF-RⅠ were measured using the method of sandwich ELISA with monoclonal and polyclonal antibodies,and blood routine and serum lactate dehydrogenase (LDH) were also detected in the CTCL and the control groups. Results The serum concentration of sIL2R from patients with CTCL was significantly higher than that of the normal control group ( P <0.01).The proportion of patients with elevated sIL2R concentration was relevant to the clinical stages.The serum level of sIL2R in tumor or erythrodermic stage was also significantly higher than that in MF Ⅰ and Ⅱ( P <0.05).The level of sIL2R decreased when the treatment was effective.No correlation was found between sIL2R and LDH level.The TNF α level was significantly higher in the CTCL group ( P < 0.01 ),while the sTNFRⅠ concentration was almost within the normal range,except 5 cases whose concentration was higher.No correlation was found between the stage of the disease and the serum concentration of sTNF-RⅠ( P >0.05). Conclusions The serum concentration of sIL2R is an useful predictor for the progress and prognosis of CTCL. The elevation of TNFα level indicates that cytokine is involved in the genesis and development of CTCL.