Pui C H, Ip S H, Thompson E, Wilimas J, Brown M, Dodge R K, de Hoyos R A, Berard C W, Crist W M
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101.
Leukemia. 1989 Jul;3(7):481-4.
To improve the biologic evaluation of Hodgkin's disease, we determined serum interleukin-2 receptor (IL2R) levels in 88 children with this tumor. In patients with stage III or IV disease, the median receptor level was significantly higher than in patients with lower stages (3195 vs. 1087 U/ml, p = 0.0001). Similarly, the median level for children with stage B disease was 3262 U/ml, compared with 999 U/ml for those lacking constitutional symptoms (p = 0.0001). Patients with very high soluble IL2R levels (greater than or equal to 5000 U/ml) were significantly more likely to fail treatment (p = 0.01), even when the analysis was restricted to groups with advanced disease: stages III and IV (p = 0.0001). When entered in the Cox-proportional hazards model with other potentially useful prognostic factors, soluble IL2R level was found to be an independent predictor of treatment outcome. The relationship of high serum IL2R levels to an adverse clinical outcome in Hodgkin's disease may be explained by a model in which the soluble receptor competes for the ligand with the cellular receptor on normal lymphocytes, thus blocking antitumor immunity dependent on interleukin-2. Alternatively, high serum levels of IL2R may simply reflect increased release of the receptor from activated malignant cells in patients with advanced disease or an otherwise poor prognosis.
为了改进霍奇金病的生物学评估，我们测定了88例患有这种肿瘤的儿童的血清白细胞介素-2受体（IL2R）水平。在III期或IV期疾病患者中，受体水平中位数显著高于疾病分期较低的患者（3195对1087 U/ml，p = 0.0001）。同样，B期疾病儿童的水平中位数为3262 U/ml，而无全身症状的儿童为999 U/ml（p = 0.0001）。可溶性IL2R水平非常高（大于或等于5000 U/ml）的患者治疗失败的可能性显著更高（p = 0.01），即使分析仅限于晚期疾病组：III期和IV期（p = 0.0001）。当将其与其他可能有用的预后因素一起纳入Cox比例风险模型时，发现可溶性IL2R水平是治疗结果的独立预测因素。霍奇金病中血清IL2R水平高与不良临床结果之间的关系可以用以下模型来解释：可溶性受体与正常淋巴细胞上的细胞受体竞争配体，从而阻断依赖白细胞介素-2的抗肿瘤免疫。或者，血清IL2R水平高可能仅仅反映了晚期疾病或预后较差患者中活化的恶性细胞释放受体增加。
