Shimomura Y, Tsurumi H, Sawada M, Yamada T, Hara T, Fukuno K, Goto H, Moriwaki H
First Department of Internal Medicine, Gifu University School of Medicine.
Rinsho Ketsueki. 1999 Aug;40(8):639-45.
The aim of this study was to assess the clinical significance of serum soluble interleukin-2 receptors (sIL-2R) in non-Hodgkin's lymphoma (NHL). Using a sandwich ELISA method, serum sIL-2R levels were measured in 720 samples from 87 patients with NHL (including 65 untreated patients) and 36 patients with other diseases such as infectious mononucleosis. The mean serum sIL-2R level in NHL was 4,017 U/ml (mean +/- SD, 4017 +/- 6352 U/ml). Patients in clinical stages III/IV (5116 +/- 6629) had significantly higher sIL-2R levels than those in clinical stages I/II (813 +/- 611). Patients with sIL-2R levels exceeding 8,000 U/ml had significantly lower survival rates (2-year survival: 12.3%) than those with sIL-2R levels below 8,000 U/ml (2-year survival: 76.0%) (P < 0.01). Multivariate analysis of variables including age, clinical stage, LDH, CRP, performance status, number of extranodal diseases, and sIL-2R demonstrated that sIL-2R and LDH were significant prognostic indicators of overall survival. The upper limit of the 95% confidence interval for maximum sIL-2R level in follow-up of patients with complete remission was 2,014 U/ml. Although an increased sIL-2R level of around 2,000 U/ml in the remission stage did not necessarily suggest relapse of NHL, it did seem to warrant careful follow-up. The serum sIL-2R level appears to reflect tumor activity and may prove to be a useful prognostic indicator in patients with NHL.
本研究旨在评估血清可溶性白细胞介素-2受体（sIL-2R）在非霍奇金淋巴瘤（NHL）中的临床意义。采用夹心酶联免疫吸附测定法，对87例NHL患者（包括65例未经治疗的患者）和36例患有其他疾病（如传染性单核细胞增多症）的患者的720份样本进行了血清sIL-2R水平检测。NHL患者的血清sIL-2R平均水平为4017 U/ml（均值±标准差，4017±6352 U/ml）。临床分期为III/IV期的患者（5116±6629）的sIL-2R水平显著高于临床分期为I/II期的患者（813±611）。sIL-2R水平超过8000 U/ml的患者的生存率（2年生存率：12.3%）显著低于sIL-2R水平低于8000 U/ml的患者（2年生存率：76.0%）（P<0.01）。对年龄、临床分期、乳酸脱氢酶（LDH）、C反应蛋白（CRP）、体能状态、结外疾病数量和sIL-2R等变量进行多因素分析表明，sIL-2R和LDH是总生存的重要预后指标。完全缓解患者随访中sIL-2R最高水平的95%置信区间上限为2014 U/ml。虽然缓解期sIL-2R水平升高至约2000 U/ml不一定提示NHL复发，但似乎确实需要密切随访。血清sIL-2R水平似乎反映肿瘤活性，可能成为NHL患者有用的预后指标。
