Milanovic N, Matkovic S, Ristic D, Jelic S, Petrovic M
Institute for Oncology and Radiology of Serbia, Medical Oncology Service, Department of Hematological Oncology, Belgrade, Serbia.
J BUON. 2012 Jul-Sep;17(3):497-501.
Lactate dehydrogenase (LDH) and beta-2 microglobulin (B2M) are incorporated in the so-called "serologic staging system", as independent parameters for predicting time to treatment failure (TTF) and overall survival (OS) for aggressive non-Hodgkin's lymphoma (NHL) patients. Elevated values of serum vascular endothelial growth factor (sVEGF) was associated with poor survival in the largest histological subgroup, the diffuse large B cell (DLBCL) and immunoblastic lymphomas. sVEGF has independent influence on survival in multivariate models when tested together with the components of the International Prognostic Index (IPI). The purpose of this study was to define possible correlations between LDH, B2M levels and the novel prognostic parameter sVEGF, with assessed tumor burden, as another parameter of aggressiveness for advanced-stage DLBCLs.
Serum samples were collected from 29 patients with DLBCL, Ann Arbor clinical stages III and IV, to measure pretreatment serum levels of LDH, B2M and sVEGF. Tumor burden was defined as low and high according to criteria's defined by Jagannath and colleagues.
A trend toward significant correlation between high initial levels of sVEGF and high tumor burden was observed (p=0.077). High serum LDH level was strongly associated with high tumor burden (p=0.0091), but B2M correlation with either low or high tumor burden was not confirmed (p=0.249). Complete response (CR) rates (CR vs. non CR) and OS according to tumor burden (low vs. high) showed no statistically significant differences (p=0.245 and p=0.202).
Our preliminary data confirmed association between serum LDH level and DLBCL burden with a satisfactory sensitivity-specificity relationship. The other two parameters, sVEGF and B2M, failed to demonstrate significant relationship with tumor burden.
乳酸脱氢酶（LDH）和β2微球蛋白（B2M）被纳入所谓的“血清学分期系统”，作为预测侵袭性非霍奇金淋巴瘤（NHL）患者治疗失败时间（TTF）和总生存期（OS）的独立参数。血清血管内皮生长因子（sVEGF）水平升高与最大组织学亚组弥漫性大B细胞淋巴瘤（DLBCL）和免疫母细胞淋巴瘤的不良生存相关。在与国际预后指数（IPI）各成分一起检测时，sVEGF在多变量模型中对生存有独立影响。本研究的目的是确定LDH、B2M水平与新的预后参数sVEGF之间可能存在的相关性，并评估肿瘤负荷，将其作为晚期DLBCL侵袭性的另一个参数。
收集29例Ann Arbor临床分期为III期和IV期的DLBCL患者的血清样本，以测量治疗前血清LDH、B2M和sVEGF水平。根据Jagannath及其同事定义的标准，将肿瘤负荷定义为低和高。
观察到sVEGF初始高水平与高肿瘤负荷之间存在显著相关趋势（p = 0.077）。血清LDH高水平与高肿瘤负荷密切相关（p = 0.0091），但未证实B2M与低或高肿瘤负荷之间存在相关性（p = 0.249）。根据肿瘤负荷（低与高）的完全缓解（CR）率（CR与非CR）和OS无统计学显著差异（p = 0.245和p = 0.202）。
我们的初步数据证实血清LDH水平与DLBCL负荷之间存在关联，具有令人满意的敏感性-特异性关系。另外两个参数sVEGF和B2M未能证明与肿瘤负荷存在显著关系。
