血清载脂蛋白C1、C反应蛋白及白介素6水平在弥漫大B细胞淋巴瘤诊断中的预测价值

The predictive value of serological indicators in the diagnosis of diffuse large B-cell lymphoma

目的:探讨载脂蛋白C1(APOC1)、C反应蛋白(CRP)及白介素6(IL-6)水平在弥漫大B细胞淋巴瘤(DLBCL)诊断中的预测价值。方法:DLBCL患者50例为DLBCL组,52例健康体检者为对照组。比较两组血清APOC1、CRP及IL-6水平,分析APOC1、CRP及IL-6水平与DLBCL临床病理特征的关系,评价其对高危及预后不良DLBCL患者的诊断价值。结果:DLBCL组血清APOC1、CRP及IL-6水平分别为419.84±204.38 ng/mL、41.87±7.98 mg/L和50.84±6.28 pg/mL,分别高于对照组的136.70±53.71 ng/mL、19.24±4.69 mg/L和36.21±10.77 pg/mL,差异均有统计学意义(P<0.05)。DLBCL高危组患者血清APOC1、CRP及IL-6水平高于低危组(P<0.05);DLBCL预后不良组血清APOC1、CRP及IL-6水平高于预后良好组(P<0.05)。血清APOC1、CRP及IL-6水平与分期及IPI评分呈正相关(P<0.05),且APOC1、CRP、IL-6三者之间具有相关性(P<0.05)。APOC1、CRP及IL-6诊断高危DLBCL患者的ROC曲线下面积(AUC)分别是0.793、0.788、0.758,三者联合检测时AUC为0.825。APOC1、CRP及IL-6诊断预后不良DLBCL患者的AUC分别是0.834、0.700、0.753,三者联合检测时AUC为0.835。结论:DLBCL患者血清APOC1、CRP及IL-6水平明显升高,可作为DLBCL潜在的诊断和预后生物标志物,三者联合检测可提高高危及预后不良DLBCL患者的诊断效能。

Objective:To investigate the predictive value of serum tumor markers apolipoprotein C1(APOC1),C-reactive protein(CRP)and interleukin-6(IL-6)in the diagnosis of diffuse large B-cell lymphoma(DLBCL).Methods:A total of 50 DLBCL patients were enrolled,and 52 healthy controls were also included.The levels of APOC1,CRP and IL-6 were detected and the relationship between the levels of APOC1,CRP and IL-6 and the clinicopathological characteristics of DLBCL was explored.The diagnostic value of APOC1,CRP and IL-6 in DLBCL patients with high risk and poor prognosis was evaluated by receiver operating characteristic(ROC)curve.Results:The levels of APOC1,CRP and IL-6 in DLBCL group were significantly higher than those in the control group(P<0.05).The APOC1,CRP and IL-6 levels of stage III-IV DLBCL patients were higher than those of stage I-II patients(P<0.05).Patients with an IPI>2 had higher levels of APOC1,CRP and IL-6 than those with an IPI≤2(P<0.05).Moreover,APOC1,CRP and IL-6 were positively correlated with staging and IPI score(P<0.05)and the three markers were related to each other(P<0.05).The area under ROC curve(AUC)of APOC1,CRP and IL-6 for high-risk DLBCL patients were 0.793,0.788 and 0.758,respectively.The AUC of APOC1,CRP and IL-6 in DLBCL patients with poor prognosis were 0.834,0.700 and 0.753,respectively.And when the three markers were combined detected,the AUC for the diagnosis of high-risk and poor prognosis of DLBCL patients increased to 0.825 and 0.835,respectively.Conclusion:The levels of APOC1,CRP and IL-6 in DLBCL patients are significantly increased,which could be used as potential diagnostic and prognostic biomarkers for DLBCL,and the combined detection of the three markers could improve the diagnostic sensitivity of DLBCL patients with high-risk and poor prognosis.