Chen Weifeng, Qiu Hongxia, Yang Xiangchou, Zhang Wei, Zhang Sujiang, Zhang Xiaoyan, Li Jianyong
Department of Hematology, First Hospital of Nanjing Medical University, Jiangsu Provincial Hospital, Nanjing 210029, China. Email:
Zhonghua Nei Ke Za Zhi. 2015 Jan;54(1):44-7.
To investigate the significance of plasma neopterin (Npt) and adenosine deaminase (ADA) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).
Serum specimens from 39 patients with newly diagnosed sHLH, 10 sHLH patients who had achieved clinical remission after treatment, and 15 healthy controls were collected.Serum Npt level was detected by enzyme linked immunosorbent assay (ELISA) and ADA activity was tested by kinetic method.
Npt and ADA values in sHLH group were significantly higher than those in control group [Npt: (164.6 ± 90.0) nmol/L vs (7.9 ± 3.6) nmol/L;ADA: (117.2 ± 70.2) U/L vs (11.6 ± 4.0) U/L;all P < 0.001]. Among the 10 sHLH patients who obtained effective clinical treatment, posttreatment levels of Npt and ADA were significantly lower than pretreatment data [Npt: (17.5 ± 10.9) nmol/L vs (170.6 ± 117.9) nmol/L;ADA: (22.5 ± 15.5) U/L vs (98.8 ± 52.6) U/L;all P < 0.05]. The Npt level in sHLH patients was positively correlated with the levels of serum soluble interleukin-2 receptor (sCD25) and serum ferritin (r = 0.526 and r = 0.507) ; while ADA activity had linear relationship with the level of lactate dehydrogenase (r = 0.646) .Receiver operating characteristic (ROC) curve analysis showed that 148.1 nmol/L was the critical value of serum Npt for the diagnosis of lymphoma associated hemophagocytic syndrome (LAHS) and the sensitivity and specificity were 70.0% and 78.9%, respectively. As to ADA, 103.1 U/L was the critical value for the diagnosis of LAHS and the sensitivity and specificity were 75.0% and 84.2%, respectively. The sensitivity and specificity of combined parameters of Npt and ADA were 90.0% and 94.7%, respectively.
It is concluded that Npt and ADA have great importance in the diagnosis and evaluation of therapeutic effect in patients with sHLH.Npt and ADA provide potential evidence to diagnose patients who are suspected with LAHS.
探讨血浆新蝶呤（Npt）和腺苷脱氨酶（ADA）在继发性噬血细胞性淋巴组织细胞增生症（sHLH）患者中的意义。
收集39例新诊断的sHLH患者、10例治疗后临床缓解的sHLH患者及15例健康对照者的血清标本。采用酶联免疫吸附测定（ELISA）法检测血清Npt水平，用动力学方法检测ADA活性。
sHLH组Npt和ADA值显著高于对照组[Npt：（164.6±90.0）nmol/L对（7.9±3.6）nmol/L；ADA：（117.2±70.2）U/L对（11.6±4.0）U/L；均P<0.001]。10例获得有效临床治疗的sHLH患者中，治疗后Npt和ADA水平显著低于治疗前数据[Npt：（17.5±10.9）nmol/L对（170.6±117.9）nmol/L；ADA：（22.5±15.5）U/L对（98.8±52.6）U/L；均P<0.05]。sHLH患者的Npt水平与血清可溶性白细胞介素-2受体（sCD25）和血清铁蛋白水平呈正相关（r=0.526和r=0.507）；而ADA活性与乳酸脱氢酶水平呈线性关系（r=0.646）。受试者工作特征（ROC）曲线分析显示，148.1 nmol/L是血清Npt诊断淋巴瘤相关噬血细胞综合征（LAHS）的临界值，敏感性和特异性分别为70.0%和78.9%。对于ADA，103.1 U/L是诊断LAHS的临界值，敏感性和特异性分别为75.0%和84.2%。Npt和ADA联合参数诊断的敏感性和特异性分别为90.0%和94.7%。
得出结论，Npt和ADA在sHLH患者的诊断及治疗效果评估中具有重要意义。Npt和ADA为诊断疑似LAHS患者提供了潜在依据。
