Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Leuk Res. 2019 Jun;81:50-55. doi: 10.1016/j.leukres.2019.04.007. Epub 2019 Apr 17.
To explore the value of elevated CXCL13 levels in Waldenström macroglobulinemia (WM).
We collected serum samples from 41 patients and bone marrow tissues from 14 patients with newly diagnosed symptomatic WM. Serum and bone marrow samples from patients with other indolent B-cell lymphomas and MGUS were also collected for comparison. Serum CXCL13 levels were measured by enzyme-linked immunosorbent assay, and bone marrow tissues were examined by immunohistochemistry.
The median serum level of CXCL13 in patients with symptomatic WM was 2483.0 (range 36.8-5644.0) pg/ml, which was significantly higher than in patients with other indolent B-cell lymphomas with monoclonal IgM (median 380.9 pg/ml, range 23.8-5518.0 pg/ml) (p = 0.01). Serum CXCL13 >3250 pg/ml and serum M-protein >38 g/l diagnosed WM with a sensitivity of 98% and specificity of 85%. Serum CXCL13 was strongly correlated with hemoglobin levels (ρ=-0.46, p = 0.002), serum M-protein (ρ=0.47, p = 0.002), and IgM levels (ρ=0.30, p = 0.05) in patients with symptomatic WM. Immunohistochemistry analysis indicated that CXCL13 and activated mast cell levels were also higher in the bone marrow of WM patients compared to patients with IgM-MGUS or other indolent B-cell lymphomas with monoclonal IgM.
Serum CXCL13 levels were significantly elevated in patients with WM and correlated with tumor load. Detection of serum CXCL13 may therefore be helpful in the differential diagnosis of WM.
探讨趋化因子 CXCL13 水平升高在华氏巨球蛋白血症（WM）中的价值。
我们收集了 41 例新诊断的有症状 WM 患者的血清样本和 14 例患者的骨髓组织样本。同时收集了其他惰性 B 细胞淋巴瘤和 MGUS 患者的血清和骨髓样本作为对照。通过酶联免疫吸附试验（ELISA）检测血清 CXCL13 水平，免疫组织化学法检测骨髓组织。
有症状 WM 患者的中位血清 CXCL13 水平为 2483.0（范围 36.8-5644.0）pg/ml，明显高于其他惰性 B 细胞淋巴瘤伴单克隆 IgM（中位 380.9 pg/ml，范围 23.8-5518.0 pg/ml）（p=0.01）。血清 CXCL13＞3250pg/ml 和血清 M 蛋白＞38g/l 诊断 WM 的敏感性为 98%，特异性为 85%。血清 CXCL13 与有症状 WM 患者的血红蛋白水平（ρ=-0.46，p=0.002）、血清 M 蛋白（ρ=0.47，p=0.002）和 IgM 水平（ρ=0.30，p=0.05）呈强相关。免疫组织化学分析表明，与 IgM-MGUS 或其他惰性 B 细胞淋巴瘤伴单克隆 IgM 相比，WM 患者的骨髓中 CXCL13 和活化的肥大细胞水平也更高。
WM 患者的血清 CXCL13 水平显著升高，并与肿瘤负荷相关。因此，检测血清 CXCL13 可能有助于 WM 的鉴别诊断。
