Chang C S, Liu H W, Lin S F, Chen T P
Department of Internal Medicine, Kaohsiung Medical College, Taiwan, ROC.
Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi. 1989 May;22(2):132-7.
An elevated serum soluble interleukin-2 receptor (SIL-2R) has been noted in various hematological malignancies and conditions associated with active T-cell responses. Its appearance has also correlated with disease activity and tumor burden. Since few studies have been reported concerning SIL-2R in cerebrospinal fluid (CSF), work was undertaken to try to find if SIL-2R could be detected in the CSF of patients with acute lymphocytic leukemia (ALL) or non-Hodgkin's lymphoma (NHL), and whether it could become a clinical predictor of the central nervous system (CNS) involvement, and its response to therapy. Preliminary results showed that 1) the CSF SIL-2R is usually detectable in very low level with a mean of 15.1 +/- 14.2 units/ml compared with the mean serum level of 338.3 +/- 135.5 units/ml in eight normal controls; 2) there was no significant difference in the mean serum and CSF SIL-2R in five patients with ALL in a complete remission state compared with normal controls, while two ALL patients with CNS relapse and two NHL patients with CNS involvement had high levels of SIL-2R in CSF. High serum and low CSF SIL-2R levels were noted in another ALL case suffering from bone marrow relapse but without CNS relapse. It was also noted that decreased CSF SIL-2R concentration occurred subsequent to intrathecal chemotherapy in two ALL patients. From these results, we conclude that CSF SIL-2R might become a useful indicator of CNS involvement in patients with hematological malignancies and may predict response to chemotherapy.
血清可溶性白细胞介素-2受体（SIL-2R）升高在各种血液系统恶性肿瘤以及与活跃T细胞反应相关的病症中均有发现。其出现也与疾病活动和肿瘤负荷相关。由于关于脑脊液（CSF）中SIL-2R的研究报道较少，因此开展了相关工作，试图探寻急性淋巴细胞白血病（ALL）或非霍奇金淋巴瘤（NHL）患者的脑脊液中是否能检测到SIL-2R，以及它是否能成为中枢神经系统（CNS）受累的临床预测指标及其对治疗的反应。初步结果显示：1）与8名正常对照者血清平均水平338.3±135.5单位/毫升相比，脑脊液SIL-2R通常以极低水平被检测到，平均为15.1±14.2单位/毫升；2）5名处于完全缓解状态的ALL患者的血清和脑脊液SIL-2R平均水平与正常对照者相比无显著差异，而2名CNS复发的ALL患者和2名CNS受累的NHL患者脑脊液中SIL-2R水平较高。在另一例骨髓复发但无CNS复发的ALL病例中，血清SIL-2R水平高而脑脊液SIL-2R水平低。还注意到2例ALL患者鞘内化疗后脑脊液SIL-2R浓度降低。从这些结果来看，我们得出结论，脑脊液SIL-2R可能成为血液系统恶性肿瘤患者CNS受累的有用指标，并可能预测化疗反应。
