血清90K/Mac-2BP对预测非霍奇金淋巴瘤化疗疗效的意义

Predictive Significance of Serum 90K/Mac-2BP on Chemotherapy Response in Non-Hodgkin's Lymphoma

背景和目的:尽管非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL)的治疗效果已经有很大的提高,但仍然有相当一部分初治患者不能取得完全缓解或取得完全缓解后又复发,如何在治疗前筛选出这部分预后不良的患者,是临床研究热点。本研究目的是探讨血清90K/Mac-2BP对初治NHL化疗近期疗效预测的意义,分析90K/Mac-2BP作为NHL肿瘤标志物的临床价值。方法:采用酶联免疫吸附(ELISA)法测定30例正常人和100例初治NHL患者90K/Mac-2BP的水平。同时分析血清90K/Mac-2BP水平与近期疗效、临床病理特征之间的关系。结果:初治NHL患者血清90K/Mac-2BP水平与患者对CHOP(CTX、ADM、VCR、Pred)方案的治疗反应有关,高水平组(血清90K/Mac-2BP平均浓度>13.62μg/ml)有效率47.6%(20/42),而低水平组(血清90K/Mac-2BP平均浓度≤13.62μg/ml)有效率93.6%(44/47)。此外,初治NHL患者血清90K/Mac-2BP水平与患者年龄、性别、病理分型、体力状态、AnnArbor分期、国际预后指数(IPI)、血清乳酸脱氢酶(lactatedehydrogenase,LDH)、骨髓侵犯以及有无巨大包块均无关(P>0.05)。结论:血清90K/Mac-2BP水平对预测采用CHOP方案进行初治的NHL患者的疗效有一定的价值。

BACKGROUND &OBJECTIVE: For newly diagnosed non Hodgkins lymphoma (NHL), CHOP regimen shows good response, but quite a few patients belong to intrinsic drug resistance, or relapse after complete remission (CR). Clinical study has been focused on screening them out and improving the therapeutic response. The purpose of this study was to explore the predictive value of serum 90K/Mac 2BP on chemotherapy response in newly diagnosed NHLs, and to analyze the potential significance of serum 90K/Mac 2BP as a tumor marker in NHLs. METHODS: Thirty healthy donors and 100 newly diagnosed patients were included in this study. Serum 90K/Mac 2BP level was measured with the quantitative sandwich enzyme linked immunosorbent assay (ELISA), and the relationship between serum 90K/Mac 2BP level and the therapeutic response as well as clinicopathological features was analyzed. RESULTS: The level of serum 90K/Mac 2BP was associated with the response of the initial treatment in patients who received CHOP (CTX, ADM, VCR, Pred) chemotherapy. The response rate in patients with higher level (mean serum level >13.62 μg/ml) of 90K/Mac 2BP was 47.6%(20/42). The response rate in patients with lower level (mean serum level ≤13.62 μg/ml) reached 93.6%(44/47) (P< 0.001). The level of serum 90K/Mac 2BP was not relevant to age, gender, pathologic classification, performance status, Ann Arbor stage, international prognostic index(IPI),serum level of lactate dehydrogenase(LDH), bone marrow involvement, and bulky disease (P >0.05). CONCLUSION: The level of serum 90K/Mac 2BP might predict the response of CHOP chemotherapy in NHLs, and is hopeful to be a new tumor marker.