非霍奇金淋巴瘤患者血清IL-2R、IL-6、IL-8、 IL-10及TNF-α的表达变化及临床意义

Changes and clinical significance of serum IL-2R,IL-6,IL-8,IL-10 and TNF-α in patients with non-Hodgkin's lymphoma

目的:探究血清IL-2R、IL-6、IL-8、IL-10、TNF-α在非霍奇金淋巴瘤(non-Hodgkin’s lymphoma,NHL)治疗中的表达变化及其临床意义。方法:收集解放军总医院第一医学中心收治的非霍奇金淋巴瘤患者63例,回顾性分析其治疗前后IL-2R、IL-6、IL-8、IL-10、TNF-α的含量变化。结果:IL-2R、IL-6及TNF-α含量在Ann Arbor分期Ⅲ-Ⅳ期、IPI评分≥3分的NHL患者中显著升高(P<0.05);IL-8含量在Hans分型non-GCB亚型和病期小于5年的患者中显著升高(P<0.05);IL-10含量在IPI评分≥3分的患者中显著升高(P<0.05)。NHL正规治疗过程中IL-2R、IL-10、TNF-α含量在CAR-T免疫疗法持续6个月完全缓解、化疗和靶向治疗的NHL患者中显著高于正常对照组(P<0.05)。与NHL标准经典一线治疗方案R-CHOP相比较,IL-2R、TNF-α含量在CDP和MOAP治疗方案中显著升高,IL-6、IL-8含量仅在CDP治疗中显著升高(P<0.05)。NHL患者CAR-T免疫疗法治疗后IL-2R含量>387 U/mL(P=0.006 7)、IL-8>12 pg/mL(P=0.047)与患者CAR-T免疫疗法复发显著相关。结论:细胞因子IL-2R、IL-6、IL-8、IL-10及TNF-α与NHL疾病的发生、发展、治疗及预后相关,或许是NHL有效的血清标志物。

Objective:To explore the variation and clinical significance of IL-2R,IL-6,IL-8,IL-10,TNF-αserum levels in non-Hodgkin's lymphoma(NHL).Method:A total of 63 NHL patients admitted to the First Medical Center,General Hospital of Chinese PLA were collected and serum levels of IL-2R,IL-6,IL-8,IL-10,and TNF-αwere restrospectively analyzed before and after treatment.Results:The serum levels of IL-2R,IL-6,and TNF-αwere significantly increased in NHL patients with Ann Arbor stageⅢ-Ⅳand IPI score≥3(P<0.05),while IL-8 level was significantly increased in non-GCB subtypes and the patients with disease duration less than 5 years(P<0.05).The IL-10 level was significantly increased in patients with an IPI score of≥3(P<0.05).During the treatment process,the levels IL-2R,IL-10,TNF-αin NHL patients who received CAR-T immunotherapy for 6 months with complete remission,chemotherapy,and targeted therapy were significantly higher than those in normal control group(P<0.05).Compared with the NHL standard classic first-line treatment regimen R-CHOP,the levels of IL-2R,TNF-αwere significantly increased in CDP and MOAP treatment regimens,while IL-6 and IL-8 levels were only significantly increased in CDP treatment(P<0.05).After CAR-T immunotherapy,IL-2R levels>387 U/mL(P=0.0067)and IL-8 levels>12 pg/mL(P=0.047)in NHL patients were significantly associated with recurrence.Conclusion:The levels of IL-2R,IL-6,IL-8,IL-10 and TNF-αwere related to the occurrence,development,treatment,and prognosis of NHL,which may be effective serum markers for NHL.