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霍奇金淋巴瘤患儿的血清可溶性白细胞介素-2受体、β2-微球蛋白、乳酸脱氢酶及红细胞沉降率

Serum soluble interleukin-2 receptor, beta2-microglobulin, lactate dehydrogenase and erythrocyte sedimentation rate in children with Hodgkin's lymphoma.

作者信息

Bien E, Balcerska A

机构信息

Department of Paediatrics, Haematology, Oncology and Endocrinology, Medical University of Gdansk, Gdansk, Poland.

出版信息

Scand J Immunol. 2009 Nov;70(5):490-500. doi: 10.1111/j.1365-3083.2009.02313.x.

Abstract

The study was to determine clinical utility of serum soluble interleukin (IL)-2 receptor (sIL-2Ralpha), beta(2)-microglobulin (beta(2)-M), lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR) as markers of diagnosis, prognosis and monitoring of response to therapy in childhood Hodgkin's lymphoma (HL). The markers were measured prospectively before treatment and in complete remission (CR) during and after therapy in 30 children with HL (F/M:19/11; median age: 11.3 years) and once in 50 healthy children (F/M: 24/26; median age: 8.7 years). Median pretreatment levels of all analysed markers were significantly higher than in healthy controls. Increased pretreatment sIL-2Ralpha, LDH and ESR correlated with bulky disease; sIL-2Ralpha, beta(2)-M and ESR with presence of B symptoms and sIL-2Ralpha and LDH with advanced HL stages. There was a correlation between sIL-2Ralpha and LDH and between beta(2)-M and ESR. The levels and rates of elevated markers reflected well the response to chemotherapy, decreasing significantly when patients achieved CR and further on with therapy continuation. Since all patients survived thus the markers' value to predict the outcome was not established. Serum sIL-2Ralpha, beta(2)-M, LDH and ESR may act as markers for diagnostics and used in monitoring of therapy effectiveness in childhood HL. The markers were also increased in subgroups of patients with unfavourable clinical features; however, small sample size of the study did not allow to draw conclusion on their prognostic roles. We were also not able to establish the influence of markers on event free survival and overall survival because all children survived independent of initial clinical characteristics and pretreatment levels of sIL-2Ralpha, beta(2)-M, LDH and ESR.

摘要

本研究旨在确定血清可溶性白细胞介素(IL)-2受体(sIL-2Rα)、β2微球蛋白(β2-M)、乳酸脱氢酶(LDH)和红细胞沉降率(ESR)作为儿童霍奇金淋巴瘤(HL)诊断、预后及治疗反应监测标志物的临床应用价值。对30例HL患儿(男/女:19/11;中位年龄:11.3岁)在治疗前、治疗期间及治疗后完全缓解(CR)时进行前瞻性标志物检测,对50例健康儿童(男/女:24/26;中位年龄:8.7岁)进行一次检测。所有分析标志物的预处理中位水平均显著高于健康对照组。预处理时sIL-2Rα、LDH和ESR升高与大包块病变相关;sIL-2Rα、β2-M和ESR与B症状的存在相关,sIL-2Rα和LDH与HL晚期相关。sIL-2Rα与LDH之间以及β2-M与ESR之间存在相关性。标志物升高的水平和速率很好地反映了化疗反应,患者达到CR时显著下降,并随着治疗的持续进一步下降。由于所有患者均存活,因此未确定标志物预测预后的价值。血清sIL-2Rα、β2-M、LDH和ESR可作为儿童HL诊断的标志物,并用于监测治疗效果。在具有不良临床特征的患者亚组中,这些标志物也升高;然而,研究样本量较小,无法就其预后作用得出结论。我们也无法确定标志物对无事件生存期和总生存期的影响,因为所有儿童均存活,与初始临床特征以及sIL-2Rα、β2-M、LDH和ESR的预处理水平无关。

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