弥漫性大B细胞淋巴瘤中的可溶性细胞间黏附分子-1（s-ICAM-1/s-CD54）：与临床特征及预后的关联

Soluble intercellular adhesion molecule-1 (s-ICAM-1/s-CD54) in diffuse large B-cell lymphoma: association with clinical characteristics and outcome.

作者信息

Terol M J, Tormo M, Martinez-Climent J A, Marugan I, Benet I, Ferrandez A, Teruel A, Ferrer R, García-Conde J

机构信息

Department of Hematology and Medical Oncology, Hospital Clínico Universitario, University of Valencia, Valencia, Spain.

出版信息

Ann Oncol. 2003 Mar;14(3):467-74. doi: 10.1093/annonc/mdg057.

DOI:10.1093/annonc/mdg057

PMID:12598355

Abstract

BACKGROUND

High serum levels of soluble intercellular adhesion molecule-1(s-ICAM-1/s-CD54) have been associated with adverse clinical features and poor outcome in chronic lymphocytic leukemia, Hodgkin's disease and non-Hodgkin's lymphoma, but their value in the different subtypes of non-Hodgkin's lymphoma has not been well addressed.

PATIENTS AND METHODS

Our aim was to study the serum levels of s-ICAM-1 in diffuse large B-cell lymphoma (DLBCL) and to correlate them with clinical characteristics and outcome. We analyzed the serum levels of s-ICAM-1 in a series of 55 patients with DLBCL diagnosed in a single institution. s-ICAM-1 levels were quantified by an immunoenzymatic assay. Median age was 62 years (range 22-96); 29 (53%) were male. Twenty-eight (51%) presented with advanced clinical stage (III/IV), 32 (58%) had extranodal involvement, 28 (51%) had high serum lactate dehydrogenase (LDH) and 23 (43%) had high beta2-microglobulin levels. All patients received anthracycline-containing regimens. Correlation between clinical variables and s-ICAM-1 levels were tested with the Mann-Whitney U-test and survival was plotted by the Kaplan-Meier method, and curves compared with the log-rank test.

RESULTS

Serum levels of s-ICAM-1 were significantly increased in patients with DLBCL compared with normal controls (589 +/- 487 versus 279 +/- 65 ng/ml, respectively; P <0.001). Higher levels of s-ICAM-1 were present in patients with B symptoms, advanced stage and increased LDH and beta2-microglobulin. s-ICAM-1 levels also correlated with achievement of a complete response. Patients with s-ICAM-1 over 668 ng/ml had a shorter time to treatment failure (TTF) (3-year TTF, 59% versus 20%, respectively; P = 0.01) and overall survival (OS) (3-year OS, 58% versus 22%, respectively; P = 0.04) than the remainders. When only low and low-intermediate risk patients in the international prognostic index score were considered, those with s-ICAM-1 over 668 ng/ml also had worse TTF and OS.

CONCLUSIONS

In DLBCL, s-ICAM-1 levels correlated with high tumor burden and lymphoma dissemination and may contribute to assessment of prognosis.

摘要

背景

血清中可溶性细胞间黏附分子-1（s-ICAM-1/s-CD54）水平升高与慢性淋巴细胞白血病、霍奇金病和非霍奇金淋巴瘤的不良临床特征及预后不良相关，但其在非霍奇金淋巴瘤不同亚型中的价值尚未得到充分研究。

患者与方法

我们的目的是研究弥漫性大B细胞淋巴瘤（DLBCL）患者血清s-ICAM-1水平，并将其与临床特征及预后相关联。我们分析了在单一机构确诊的55例DLBCL患者的血清s-ICAM-1水平。通过免疫酶测定法定量s-ICAM-1水平。中位年龄为62岁（范围22 - 96岁）；29例（53%）为男性。28例（51%）表现为晚期临床分期（III/IV期），32例（58%）有结外受累，28例（51%）血清乳酸脱氢酶（LDH）升高，23例（43%）β2微球蛋白水平升高。所有患者均接受含蒽环类药物的方案治疗。临床变量与s-ICAM-1水平之间的相关性采用Mann-Whitney U检验进行测试，生存情况通过Kaplan-Meier方法绘制，曲线采用对数秩检验进行比较。

结果

与正常对照组相比，DLBCL患者血清s-ICAM-1水平显著升高（分别为589±487与279±65 ng/ml；P<0.001）。有B症状、晚期、LDH和β2微球蛋白升高的患者s-ICAM-1水平较高。s-ICAM-1水平还与完全缓解的达成相关。s-ICAM-1超过668 ng/ml的患者治疗失败时间（TTF）较短（3年TTF分别为59%与20%；P = 0.01），总生存期（OS）也较短（3年OS分别为58%与22%；P = 0.04）。当仅考虑国际预后指数评分中的低和低-中危患者时，s-ICAM-1超过668 ng/ml的患者TTF和OS也较差。