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可溶性白细胞介素2受体(sIL2R)在晚期肺癌化疗监测中的应用

Soluble interleukin 2 receptor (sIL2R) in monitoring advanced lung cancer during chemotherapy.

作者信息

Brunetti G, Bossi A, Baiardi P, Jedrychowska I, Pozzi U, Bacchella L, Bernardo G

机构信息

Department of Internal Medicine, Salvatore Maugeri Foundation, Pavia, Italy.

出版信息

Lung Cancer. 1999 Jan;23(1):1-9. doi: 10.1016/s0169-5002(98)00094-4.

Abstract

STUDY OBJECTIVES

To evaluate the usefulness of measuring sIL2R for diagnostic and prognostic purposes and for monitoring disease during a 6-month period of chemotherapy, and to investigate the clinical significance of sIL2R serum concentrations.

METHODS

The serum concentration of sIL2R, TPA and lymphocyte subsets CD4, CD8, CD25, CD16 were measured at diagnosis and then 1 and 6 months after the start of chemotherapy.

PATIENTS

There were 39 patients (three females, 36 males; mean age 61.6 years) with lung cancer (LC), treated with chemotherapy and 22 control subjects (six females, 16 males; mean age 50.1 years) with non-neoplastic lung diseases.

RESULTS

No significant differences in sIL2R serum concentrations were observed at diagnosis between the control and LC group or when comparing the different histotypes, disease stages (IIIa-b vs IV) and survival (survival < or = 12 vs > 12 months). On comparing the sequential variations of the examined parameters a significant increase in sIL2R (P < 0.007) after 1 and 6 months versus basal value was observed only in patients surviving less than 12 months and in those who did not respond to chemotherapy. Moreover a negative correlation was observed between sIL2R serum concentrations and CD25+ and CD16+ lymphocyte subsets. Evaluation of survival curves of patients with basal sIL2R > or < or = 700 U/ml showed a slightly lower survival rate in the former group.

CONCLUSIONS

The present results, confirming the poor utility of sIL2R in the diagnostic phase of the disease, show its usefulness in prognostic evaluation and in the clinical surveillance of patients with advanced lung cancer submitted to polychemotherapy. In this case any variations in sIL2R serum levels are likely to relate to the spread of the neoplasia rather than to the host immune response.

摘要

研究目的

评估测量可溶性白细胞介素2受体(sIL2R)用于诊断和预后目的以及在6个月化疗期间监测疾病的实用性,并探讨sIL2R血清浓度的临床意义。

方法

在诊断时以及化疗开始后1个月和6个月测量sIL2R、组织多肽抗原(TPA)以及淋巴细胞亚群CD4、CD8、CD25、CD16的血清浓度。

患者

39例肺癌(LC)患者(3例女性,36例男性;平均年龄61.6岁)接受化疗,22例对照受试者(6例女性,16例男性;平均年龄50.1岁)患有非肿瘤性肺部疾病。

结果

在诊断时,对照组和肺癌组之间,或者比较不同组织学类型、疾病分期(IIIa - b期与IV期)和生存期(生存期≤12个月与>12个月)时,未观察到sIL2R血清浓度有显著差异。比较所检测参数的连续变化时,仅在生存期小于12个月的患者以及对化疗无反应的患者中,观察到1个月和6个月后sIL2R相对于基础值有显著升高(P<0.007)。此外,观察到sIL2R血清浓度与CD25⁺和CD16⁺淋巴细胞亚群之间呈负相关。对基础sIL2R>或≤700 U/ml的患者的生存曲线评估显示,前一组的生存率略低。

结论

目前的结果证实了sIL2R在疾病诊断阶段效用不佳,但显示了其在预后评估以及接受多药化疗的晚期肺癌患者临床监测中的有用性。在这种情况下,sIL2R血清水平的任何变化可能与肿瘤的扩散有关,而非与宿主免疫反应有关。

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