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sIL-2R:原发性肾上腺淋巴瘤的新型诊断生物标志物。

sIL-2R: A Novel Diagnostic Biomarker for Primary Adrenal Lymphoma.

机构信息

Adrenal Center, Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China.

Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, P. R. China.

出版信息

J Clin Endocrinol Metab. 2022 May 17;107(6):e2284-e2290. doi: 10.1210/clinem/dgac131.

Abstract

CONTEXT

Primary adrenal lymphoma (PAL) is difficult to distinguish from other adrenal masses. Soluble interleukin-2 receptor (sIL-2R) is a diagnostic biomarker for nodal non-Hodgkin lymphoma, whose association with PAL is unknown.

OBJECTIVE

The aim of this study was to determine the diagnostic utility of serum sIL-2R for Patients with PAL.

DESIGN

Prospective cohort study.

SETTINGS AND PARTICIPANTS

A total of 118 patients with adrenal masses who were willing to be tested for levels of serum sIL-2R from a tertiary hospital between 2019 and 2021 were included.

MAIN OUTCOMES AND MEASURES

Serum sIL-2R and lactate dehydrogenase (LDH) levels.

RESULTS

Patients with PAL had significantly higher sIL-2R levels than those of patients with other adrenal masses with indetermined and benign computed tomography (CT) features (both Ps < 0.001). The LDH levels of patients with PAL were also significantly higher than those of patients with other adrenal masses with indeterminate and benign CT features (both Ps < 0.001). Good discrimination of patients with PAL from other patients (PAL vs other adrenal masses with indeterminate CT features/non-PAL) was achieved with an area under the receiver operating characteristic curve (AUC) of 0.984 (95% CI, 0.95-1)/0.992 (95% CI, 0.975-1.000) using the serum levels of sIL-2R and further improved (AUC = 0.998, 95% CI, 0.994-1.000; AUC = 0.999, 95% CI, 0.996-1.000) after adjusting by LDH category.

CONCLUSIONS

For the first time, we have identified that serum sIL-2R and LDH category-adjusted sIL-2R levels have good diagnostic performances for PAL.

摘要

背景

原发性肾上腺淋巴瘤(PAL)很难与其他肾上腺肿块区分。可溶性白细胞介素 2 受体(sIL-2R)是结外非霍奇金淋巴瘤的诊断生物标志物,其与 PAL 的关系尚不清楚。

目的

本研究旨在确定血清 sIL-2R 对 PAL 患者的诊断效用。

设计

前瞻性队列研究。

地点和参与者

共有 118 名来自一家三甲医院的愿意接受血清 sIL-2R 水平检测的肾上腺肿块患者,于 2019 年至 2021 年期间入组。

主要结局和措施

血清 sIL-2R 和乳酸脱氢酶(LDH)水平。

结果

与 CT 特征不确定且良性的其他肾上腺肿块患者相比,PAL 患者的 sIL-2R 水平显著更高(均 P<0.001)。PAL 患者的 LDH 水平也显著高于 CT 特征不确定且良性的其他肾上腺肿块患者(均 P<0.001)。PAL 患者与其他 CT 特征不确定的肾上腺肿块患者(PAL 与其他 CT 特征不确定的肾上腺肿块/非-PAL)之间的良好区分,通过 sIL-2R 血清水平的受试者工作特征曲线(ROC)曲线下面积(AUC)为 0.984(95%CI,0.95-1)/0.992(95%CI,0.975-1.000)实现,进一步通过 LDH 类别调整后(AUC=0.998,95%CI,0.994-1.000;AUC=0.999,95%CI,0.996-1.000)得到改善。

结论

我们首次发现,血清 sIL-2R 和 LDH 类别调整后的 sIL-2R 水平对 PAL 具有良好的诊断性能。

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