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血清25-羟维生素D[25(OH)D]浓度对淋巴系统恶性肿瘤患者的预后影响

Prognostic impact of serum 25-hydroxivitamin D [25(OH)D] concentrations in patients with lymphoid malignancies.

作者信息

Aref Salah, Ibrahim Lamiaa, Azmy Emaad

机构信息

Hematology Unit, Clinical Pathology Department, Mansoura University, Mansoura 3011, Egypt.

出版信息

Hematology. 2013 Jan;18(1):20-5. doi: 10.1179/1607845412Y.0000000025. Epub 2012 Sep 12.

Abstract

The incidence of lymphoid malignancies has been increasing rapidly. Despite growing evidence for a relationship between serum 25-hydroxivitamin D [25(OH)D] concentrations and solid tumor risk, far less is known about the relationship between 25(OH)D and the risk of hematologic malignancy. This study aimed to assess the prognostic relevance of serum 25(OH)D concentrations in patients with B chronic lymphocytic leukemia (B-CLL) and non Hodgkin's lymphoma (NHL). The study was carried out on 195 newly diagnosed patients (75 B-CLL and 120 NHL) as well as 30 normal healthy controls. For all patients and normal controls serum 25(OH)D concentrations were assayed by enzyme-linked immunosorbent assay. Serum 25(OH)D levels were significantly lower in B-CLL and NHL patients as compared with normal controls (P = 0.00 for both). Also, there are significant associations between serum 25(OH)D levels and positive CD 38, positive ZAP 70 as well as Binet stages (χ(2) = 16.071, 16.644, 21.134 respectively; P = 0.00 for all) in the B-CLL patient group. Moreover, there are significant associations between serum 25(OH)D status and international prognostic index (IPI), performance status (χ(2) = 6.994, 9.212, P = 0.02, 0.01 respectively), but not with clinical stages (χ(2) = 3.115, P = 0.539) in NHL. Multivariate analysis revealed that 25(OH)D insufficiency is an independent poor prognostic factor in both B-CLL and NHL patient groups. In conclusion, 25(OH)D insufficiency is an independent poor prognostic factor in patients with B-CLL and NHL. 25(OH)D might be a therapeutic target in lymphoid malignancies.

摘要

淋巴系统恶性肿瘤的发病率一直在迅速上升。尽管越来越多的证据表明血清25-羟基维生素D[25(OH)D]浓度与实体瘤风险之间存在关联,但关于25(OH)D与血液系统恶性肿瘤风险之间的关系却知之甚少。本研究旨在评估血清25(OH)D浓度对B细胞慢性淋巴细胞白血病(B-CLL)和非霍奇金淋巴瘤(NHL)患者的预后相关性。该研究对195例新诊断患者(75例B-CLL和120例NHL)以及30名正常健康对照者进行。对所有患者和正常对照者采用酶联免疫吸附测定法检测血清25(OH)D浓度。与正常对照相比,B-CLL和NHL患者的血清25(OH)D水平显著降低(两者P值均为0.00)。此外,在B-CLL患者组中,血清25(OH)D水平与CD38阳性、ZAP 70阳性以及Binet分期之间存在显著关联(χ(2)分别为16.071、16.644、21.134;所有P值均为0.00)。此外,在NHL中,血清25(OH)D状态与国际预后指数(IPI)、体能状态之间存在显著关联(χ(2)分别为6.994、9.212,P值分别为0.02、0.01),但与临床分期无关(χ(2)=3.115,P=0.539)。多因素分析显示,25(OH)D不足是B-CLL和NHL患者组中一个独立的不良预后因素。总之,25(OH)D不足是B-CLL和NHL患者的一个独立不良预后因素。25(OH)D可能是淋巴系统恶性肿瘤的一个治疗靶点。

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