Chu Na-Li, Zhang Jing-Yu, Guo Li, Xu Di, Fan Hong
Department of Laboratory Diagnosis，Cangzhou Hospital of Integrated of Traditional Chinese and Western Medicine of Hebei Province， Cangzhou 061001, Hebei Province, China.
Department of Hematology，Cangzhou Hospital of Integrated of Traditional Chinese and Western Medicine of Hebei Province， Cangzhou 061001, Hebei Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Oct;28(5):1625-1630. doi: 10.19746/j.cnki.issn.1009-2137.2020.05.032.
To investigate the expression level and the clinical significance of serum interleukin-6(IL-6) , IL-10, tumor necrosis factor α(TNF-α) and β-microglobulin(β-MG) in multiple myeloma(MM) patients with different blood separation results.
The clinical data of 124 newly diagnosed MM patients (76 cases of IgG type, 48 cases of IgA type) treated in our hospital from October 2015 to October 2019 were enrolled and analyzed. The blood samples were divided into control group (the order from top to bottom is serum, separator gel and red blood cells) and abnormal group (the order from top to bottom is serum, red blood cells, separator gel and red blood cells) according to the blood separation result. The differences of expression level in serum IL-6, IL-10, TNF-α and β-MG were compared between the two groups, and the changes of blood separation result and different indexes were analyzed after treatment.
Abnormal separation results were found in 21 cases (16.94%), including 13 cases of IgG type and 8 cases of IgA type. The levels of serum IL-6, IL-10, TNF-α and β-MG in abnormal group were significantly higher than those in control group (P<0.05) . After treatment, 85 patients in control group (103 cases) achieved complete remission (CR) or very good partial remission (VGPR) and partial remission(PR). The results of blood separation showed no change. 18 patients achieved less than PR, and the separation result in 5 patients changed from normal to abnormal separation. The blood separation of 9 patients with CR and VGPR in abnormal group (21 cases) were changed from abnormal to normal. 8 patients achieved PR, and the separation result in 6 patients were changed from abnormal to normal and 2 cases showed no change, while the blood separation showed no changes in 4 cases MM patients who achieved less than PR in abnormal group. The expression levels of IL-6, IL-10, TNF-α and β-MG of patients in control group transformed to abnormal blood separation result after treatment showed significantly higher than those before treatment (P<0.05) , and the levels of IL-6 and β-MG were significantly lower in the patients with out change in blood separation results than those before treatment (P<0.05). The serum levels of IL-6, IL-10, TNF-α and β-MG of patients in abnormal group transformed to normal blood separation after treatment were significantly lower than those before treatment (P<0.05), and the serum levels of IL-6, IL-10, TNF-α and β-MG in abnormal group with no changes in blood separation results showed not significantly different from those before treatment (P>0.05).
Abnormal separation phenomenon can be found after centrifugation in patients with multiple myeloma. The expression levels of serum IL-6, IL-10, TNF-α and β-MG in MM patients with different blood separation results are different, which suggesting different degrees of tumor burden. The changes of blood separation result and levels of IL-6, IL-10, TNF-α and β-MG after treatment can predict the therapeutic effect, and also provide the experimental basis for the evaluation of disease condition and prognosis of patients with different blood separation results.
探讨不同血液分离结果的多发性骨髓瘤（MM）患者血清白细胞介素-6（IL-6）、IL-10、肿瘤坏死因子α（TNF-α）和β2微球蛋白（β-MG）的表达水平及临床意义。
纳入并分析2015年10月至2019年10月在我院治疗的124例新诊断MM患者（IgG型76例，IgA型48例）的临床资料。根据血液分离结果将血样分为对照组（自上而下依次为血清、分离胶和红细胞）和异常组（自上而下依次为血清、红细胞、分离胶和红细胞）。比较两组血清IL-6、IL-10、TNF-α和β-MG表达水平的差异，并分析治疗后血液分离结果及不同指标的变化。
发现21例（16.94%）分离结果异常，其中IgG型13例，IgA型8例。异常组血清IL-6、IL-10、TNF-α和β-MG水平显著高于对照组（P<0.0⁵）。治疗后，对照组103例中的85例患者达到完全缓解（CR）或非常好的部分缓解（VGPR）及部分缓解（PR）。血液分离结果无变化。18例患者缓解程度低于PR，5例患者的分离结果从正常变为异常分离。异常组21例中9例CR和VGPR患者的血液分离从异常变为正常。8例患者达到PR，6例患者的分离结果从异常变为正常，2例无变化，而异常组中4例缓解程度低于PR的MM患者血液分离无变化。对照组治疗后血液分离结果转为异常的患者IL-6、IL-10、TNF-α和β-MG表达水平显著高于治疗前（P<0.0⁵），血液分离结果无变化的患者IL-6和β-MG水平显著低于治疗前（P<0.0⁵）。异常组治疗后血液分离转为正常的患者血清IL-6、IL-10、TNF-α和β-MG水平显著低于治疗前（P<0.0⁵），血液分离结果无变化的异常组患者血清IL-6, IL-10, TNF-α和β-MG水平与治疗前相比差异无统计学意义（P>0.0⁵）。
多发性骨髓瘤患者离心后可出现异常分离现象。不同血液分离结果的MM患者血清IL-6、IL-10、TNF-α和β-MG表达水平不同，提示肿瘤负荷程度不同。治疗后血液分离结果及IL-6、IL-10、TNF-α和β-MG水平的变化可预测治疗效果，也为评估不同血液分离结果患者的病情及预后提供实验依据。
