初诊弥漫大B细胞淋巴瘤患者血清CEA、IL-17、PIC水平变化及意义

Changes in levels of serum CEA,IL-17,and PIC in patients with newly diagnosed diffuse large B-cell lymphoma and the significance

目的 探讨弥漫大B细胞淋巴瘤(DLBCL)患者血清癌胚抗原(CEA)、IL-17和纤溶酶-α2纤溶酶抑制剂复合物(PIC)的水平变化及意义。方法 选取DLBCL患者103例(DLBCL组),同期选择32名健康体检者作为对照组。DLBCL组采用R-CHOP(利妥昔单抗+环磷酰胺,多柔比星、长春新碱和泼尼松)方案化疗,化疗结束后行全身影像学检查,对疗效进行评估,将103例患者分为化疗有效组44例,化疗无效组59例。分别于对照组健康体检时、DLBCL组化疗前用酶联免疫吸附法检测血清IL-17,用化学发光免疫分析法检测血清CEA、PIC。绘制受试者工作特征曲线,用曲线下面积比较血清CEA、IL-17、PIC水平及联合检测对疗效的预测价值。结果 与对照组比较,DLBCL组血清CEA、PIC水平高,血清IL-17水平低(P均<0.05)。DLBCL患者血清CEA、IL-17、PIC水平与结外受累的器官、淋巴结数目、国际预后指数评分(IPI)、临床分期有关(P均<0.05),与性别、年龄无关(P均>0.05)。与化疗有效组比较,化疗无效组血清CEA、PIC水平高,IL-17水平低(P均<0.05)。血清CEA、IL-17、PIC及三者联合预测疗效的曲线下面积分别为0.676、0.757、0.684、0.830。三者联合预测的曲线下面积高于三者单独预测(P均<0.05)。结论 DLBCL患者血清CEA、PIC水平升高,血清IL-17水平降低;三者水平变化与结外侵犯部位数目、IPI评分、临床分期有关,且联合检测可预测DLBCL患者化疗疗效。

Objective To investigate the changes in serum levels of carcinogerm antigen(CEA), interleukin-17(IL-17), and plasminase-α2 plasminase inhibitor complex(PIC) in patients with diffuse large B-cell lymphoma(DLBCL) and their significance. Methods Totally 103 patients with DLBCL(DLBCL group) were selected, and 32 healthy people were selected as the control group at the same time. Patients in the DLBCL group were treated with R-CHOP regimen.After chemotherapy, the efficacy was evaluated by whole body imaging, and then 103 patients were divided into effective chemotherapy group(44 cases) and ineffective chemotherapy group(59 cases). Serum IL-17 was detected by ELISA and serum CEA and PIC were detected by chemiluminescence immunoassay at the time of health examination in the control group and before chemotherapy in DLBCL group. Receiver operating characteristic(ROC) curve was drawn, and the area under the curve was used to compare the predictive value of serum CEA, IL-17, PIC level and combined detection for the efficacy. Results Compared with the control group, the serum CEA and PIC levels in the DLBCL group were higher, and the serum IL-17 level was lower(all P<0. 05). Serum CEA, IL-17, PIC levels in patients with DLBCL were related to extranodal organs involved, the number of lymph nodes, international prognostic index(IPI) score, and clinical stage(all P<0. 05), but not to gender or age(all P>0. 05). Compared with the effective chemotherapy group, the levels of serum CEA and PIC were higher, and the level of IL-17 was lower in the ineffective chemotherapy group(all P<0. 05). The area under the curve of serum CEA, IL-17, PIC and them combined in predicting the efficacy were 0. 676, 0. 757, 0. 684 and 0. 830, respectively. The area under the curve of the three jointly in predicting the the efficacy was higher than that of the three methods alone(all P<0. 05). Conclusion Serum CEA and PIC levels increased in patients with DLBCL, while serum IL-17 levels decreased;the changes of the three levels were related to the number of extranodal invasion sites, IPI score and clinical stage, and combined detection could predict the chemotherapy effect of DLBCL patients.