弥漫大B细胞淋巴瘤并乙型肝炎病毒感染血清sIL-2r、Flt3L、cTfh水平及与预后的关系

Changes of serum sIL-2r,Flt3L and cTfh in diffuse large B-cell lymphoma patients complicated with hepatis B virus infection and association with prognosis

目的探讨弥漫大B细胞淋巴瘤(DLBCL)并乙型肝炎病毒(HBV)感染患者血清可溶性白细胞介素-2受体(sIL-2r)、Fms相关酪氨酸激酶3配体(Flt3L)、循环辅助T细胞(cTfh)水平及与预后的关系.方法选取2019年3月-2022年3月在新乡医学院第一附属医院收治的60例DLBCL并HBV感染患者为合并HBV组,选取同期收治的60例DLBCL未合并HBV感染患者为未合并HBV组,均在治疗前检测血清sIL-2r、Flt3L、cTfh水平.另选取30名健康志愿者为健康对照组.比较各组间指标水平差异.比较两组患者1年生存差异.利用受试者工作特征(ROC)曲线和多因素COX分析各指标与DLBCL并HBV感染患者预后关系.结果DLBCL患者血清sIL-2r、Flt3L、cTfh水平均高于健康对照组(P<0.05);合并HBV组血清sIL-2r、cTfh、Flt3L水平均高于未合并HBV组(P<0.05).合并HBV组无进展生存率、总生存率均低于未合并HBV组(P<0.05).ROC分析结果显示,sIL-2r、Flt3L、cTfh均具有预测DLBCL并HBV患者的预后价值(P<0.05).多因素COX分析结果显示,淋巴瘤分期(AnnArbor)、非霍奇金淋巴瘤预后(IPI)评分、sIL-2r、Flt3L、cTfh是影响患者预后的危险因素(P<0.05).结论HBV感染可影响DLBCL患者预后,DLBCL并HBV感染患者血清sIL-2r、Flt3L、cTfh高表达,具有预测预后的价值,且Flt3L是影响预后的危险因素.

OBJECTIVE To explore the changes of serum soluble interleukin-2 receptor(sIL-2r),Fms-related tyro-sine kinase 3 ligand(Flt3L)and circulating helper T cells(cTfh)in the diffuse large B-cell lymphoma(DLBCL)patients complicated with hepatitis B virus(HBV)infection and analyze the association with prognosis.METHODS Totally 60 DLBCL patients complicated with HBV infection who were treated in the First Affiliated Hospital of Xinxiang Medical University from Mar 2019 to Mar 2022 were assigned as the HBV complication group,mean-while,60 DLBCL patients who were not complicated with HBV infection were chosen as the no HBV complication group.The levels of serum sIL-2r,Flt3L and cTfh were detected for the two groups of patients before the treat-ment.30 healthy volunteers were chosen as the healthy control group.The levels of the indexes were compared a-mong the three groups,the 1-year survival status was compared between the two groups of patients.The associa-tion between the indexes and the prognosis of the DLBCL patients complicated with HBV infection was analyzed by means of receiver operating characteristic(ROC)curves and multivariate COX analysis.RESULTS The levels of serum sIL-2r,Flt3L and cTfh of the DLBCL patients were higher than those of the healthy control group(P<0.05);the level of serum sIL-2r,cTfh and Flt3L of the HBV complication group were higher than those of the no HBV complication group(P<0.05).The progression-free survival rate and the total survival rate were lower in the HBV complication group than in the no HBV complication group(P<0.05).ROC analysis showed that the sIL-2r,Flt3L and cTfh had the values in prediction of the prognosis of the DLBCL patients complicated with HBV infection(P<0.05).Multivariate COX analysis indicated that lymphoma stage(AnnArbor),international prognos-tic index for non-Hodgkin's lymphoma(IPI)score,sIL-2r,Flt3L and cTfh were the risk factors for the prognosis of the patients(P<0.05).CONCLUSION The HBV infection may affect the prognosis of the DLBCL patients.The DLBCL patients complicated with HBV infection show the high expressions of serum sIL-2r,Flt3L and cTfh,which have the values in prediction of the prognosis.Flt3L is the risk factor for the prognosis.