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细胞因子:淋巴瘤病例中有用的预后标志物

Cytokines : as useful Prognostic Markers in Lymphoma Cases.

作者信息

Chopra G S, Chitalkar P G, Jaiprakash M P

机构信息

Senior Adviser (Pathology & Immunology), Army Hospital (R&R), Delhi Cantt.

Classified Specialist (Medicine & Oncology), Command Hospital (Southern Command), Pune - 411 040.

出版信息

Med J Armed Forces India. 2004 Jan;60(1):45-9. doi: 10.1016/S0377-1237(04)80158-8. Epub 2011 Jul 21.

Abstract

Cytokines are believed to be involved in the pathogenesis and enhanced expression in patients with Hodgkin's and Non-Hodgkins lymphoma. Based on this phenomenon, a multicentric study was carried out in various lymphoma cases. The diagnosis of lymphoma was made on tissue biopsies and fine needle aspiration cytology (FNAC). Out of a total of 72 cases studied, 45 were of Hodgkin's lymphoma (62.5%) and 27 cases were of Non-Hodgkin's lymphoma (37.5%). Maximum cases of Hodgkin's disease occurred in the age group of 30-40 years and males outnumbered females. Hodgkin's lymphoma cases were predominantly of mixed cellularity histologic type (46.66%) whereas majority cases of Non-Hodgkin's lymphoma were of high grade histologic type (48.14%) with predominance in the age group 51-60 years. In both these type of lymphomas, the IL-2R and IL-6 levels were found to be increased more than four fold (as compared to healthy controls) (p<0.05). The cytokine levels decreased after chemotherapy in patients showing response to therapy. However, there were few conflicting and unreliable trends in the IL-6 levels after chemotherapy where elevated IL-6 levels persisted in patients in clinical remission. Overall, it was seen that both IL-2R and IL-6 can be used as an indicator for assessing prognosis and drug therapy in lymphoma cases. IL-2R was found to be a better prognostic marker than IL-6 in assessing the response of lymphoma patient to chemotherapy, more so in Hodgkin's disease.

摘要

细胞因子被认为参与了霍奇金淋巴瘤和非霍奇金淋巴瘤患者的发病机制并在其中表达增强。基于这一现象,针对各类淋巴瘤病例开展了一项多中心研究。淋巴瘤的诊断基于组织活检和细针穿刺细胞学检查(FNAC)。在总共研究的72例病例中,45例为霍奇金淋巴瘤(62.5%),27例为非霍奇金淋巴瘤(37.5%)。霍奇金病的最大发病病例数出现在30 - 40岁年龄组,男性多于女性。霍奇金淋巴瘤病例主要为混合细胞型组织学类型(46.66%),而非霍奇金淋巴瘤的大多数病例为高级别组织学类型(48.14%),在51 - 60岁年龄组占优势。在这两种类型的淋巴瘤中,发现白细胞介素 - 2受体(IL - 2R)和白细胞介素 - 6(IL - 6)水平比健康对照升高了四倍多(p<0.05)。对治疗有反应的患者化疗后细胞因子水平下降。然而,化疗后IL - 6水平存在一些相互矛盾且不可靠的趋势,临床缓解的患者中IL - 6水平持续升高。总体而言,可以看出IL - 2R和IL - 6均可作为评估淋巴瘤病例预后和药物治疗的指标。在评估淋巴瘤患者对化疗的反应方面,发现IL - 2R比IL - 6是更好的预后标志物,在霍奇金病中更是如此。

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