Lyu Xin, Wang Yue, Wang Ling-Ling, Yin Guang-Li, Liu Ling-Ling, Duan Li-Min, Tian Tian, Xu Ji, Qiu Hong-Xia
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu province, China,Department of Hematology, Linyi Central Hosiptal, Yishui 276400, Shandong Province, China.
Department of Hematology, Linyi Central Hosiptal, Yishui 276400, Shandong Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Jun;28(3):1006-1011. doi: 10.19746/j.cnki.issn.1009-2137.2020.03.048.
To investigate the expression and clinical significance of soluble B7-H3 (sB7-H3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).
The plasma samples of 85 newly diagnosed sHLH patients from December 2012 to April 2018 were collected. The patients were divided into lymphoma-related HLH（LHLH）group and infection-related HLH（IHLH）group. The expression of sB7-H3 in plasma was detected by ELISA, and the clinical data were collected for analysis. Fifteen healthy people were chosen as control group.
The expression level of sB7-H3 in lymphoma-related HLH and infection-related HLH group significant increased as compared with the control group, (P＜0.05), and the expression level of sB7-H3 in lymphoma-related HLH group was significant higher than that in infection-related HLH group [(35.75± 9.90) vs (28.70±8.95) ng/ml)] (P＜0.001). There were no significant statistical difference in the expression of some clinical factors (including age, fever, splenomegaly, ANC, Plt, FIB, calcium ion, serum albumin, LDH, serum ferritin, sCD25) in lymphoma-related HLH and infection-related HLH group (P＞0.05). The evaluation of expression and significance of sB7-H3 in sHLH by using ROC curve, showed that the area under ROC curve comparison of patients in lymphoma-related HLH group and infection-related HLH group was 0.718 (95% CI 0.610-0.810) (P=0.0002), and predicting the sensitivity and specificity of the lymphoma-related HLH patients were 77.36% and 59.38%, respectively. The best cut-off value of patients in sB7-H3 was 29.81 ng/ml, the overall survival time of sB7-H3 high-expression group (≥29.81 ng/ml) was significant shorter than that in low-expression group (＜29.81 ng/ml) (24 vs 440 d) (P＜0.001). The clinical factors affecting the survival status of sHLH patients were neutrophils, albumin, serum ferritin, serum calcium ions and sB7-H3 levels.
sB7-H3 associates with poor prognosis of sHLH patients, and may be involved in disease progression.
探讨可溶性B7-H3（sB7-H3）在继发性噬血细胞性淋巴组织细胞增生症（sHLH）患者中的表达及临床意义。
收集2012年12月至2018年4月期间85例新诊断的sHLH患者的血浆样本。将患者分为淋巴瘤相关HLH（LHLH）组和感染相关HLH（IHLH）组。采用酶联免疫吸附测定法（ELISA）检测血浆中sB7-H3的表达，并收集临床资料进行分析。选取15名健康人作为对照组。
淋巴瘤相关HLH组和感染相关HLH组sB7-H3的表达水平与对照组相比显著升高（P＜0.05），且淋巴瘤相关HLH组sB7-H3的表达水平显著高于感染相关HLH组[（35.75±9.90） vs （28.70±8.95） ng/ml]（P＜0.001）。淋巴瘤相关HLH组和感染相关HLH组在一些临床因素（包括年龄、发热、脾肿大、中性粒细胞计数、血小板计数、纤维蛋白原、钙离子、血清白蛋白、乳酸脱氢酶、血清铁蛋白、可溶性白细胞介素-2受体）的表达上无显著统计学差异（P＞0.05）。采用ROC曲线评估sHLH中sB7-H3的表达及意义，结果显示淋巴瘤相关HLH组和感染相关HLH组患者的ROC曲线下面积比较为0.718（95%可信区间0.610-0.810）（P=0.0002），预测淋巴瘤相关HLH患者的敏感性和特异性分别为77.36%和59.38%。sB7-H3患者的最佳截断值为29.81 ng/ml，sB7-H3高表达组（≥29.81 ng/ml）的总生存时间显著短于低表达组（＜29.81 ng/ml）（24 vs 440 d）（P＜0.001）。影响sHLH患者生存状态的临床因素为中性粒细胞、白蛋白、血清铁蛋白、血清钙离子和sB7-H3水平。
sB7-H3与sHLH患者的不良预后相关，可能参与疾病进展。
