Department of Hematology, The First People's Hospital of Yunnan Province, Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Yunnan Blood Disease Clinical Medical Center, The First People's Hospital of Yunnan Province, Kunming, China.
Front Cell Infect Microbiol. 2022 Apr 8;12:860526. doi: 10.3389/fcimb.2022.860526. eCollection 2022.
Non-Hodgkin's lymphoma (NHL) is a form of tumor that originates in the lymphoid tissues. Bacterial infections are very common in NHL patients. Because most of the patients do not experience apparent symptoms during the initial stage of infection, it is difficult to detect the underlying condition before it progresses to a more critical level. The activation of the cytokines is a hallmark of inflammation. Due to the advantages of short detection time and high sensitivity of cytokines, many studies have focused on relationship between cytokines and infection. However, few studies have been conducted on NHL patients with infection. Therefore, we reviewed the cytokine profiles of 229 newly diagnosed NHL patients and 40 healthy adults to predict respiratory bacterial infection and bacteremia. Our findings revealed that IL-6(41.67 vs 9.50 pg/mL), IL-8(15.55 vs 6.61 pg/mL), IL-10(8.02 vs 4.52 pg/mL),TNF-β(3.82 vs 2.96 pg/mL), IFN- γ(4.76 vs 2.96 pg/mL), body temperature(37.6 vs 36.5°C), CRP(20.80 vs 4.37 mg/L), and PCT(0.10 vs 0.04 ng/mL) levels were considerably greater in NHL cases with respiratory bacterial infections relative to NHL cases without infection (P<0.05). Furthermore, IL-6(145.00 vs 41.67 pg/mL), IL-8(34.60 vs 15.55 pg/mL),temperature(38.4 vs 37.6°C), PCT(0.79 vs 0.10 ng/mL), and CRP(93.70 vs 20.80 mg/L) levels in respiratory infectious NHL patients with more severe bacteremia were considerably elevated than in patients with respiratory bacterial infections only (P<0.05). Remarkably, increased levels of IL-6 and IL-8 are effective in determining whether or not pulmonary bacterial infectious NHL patients have bacteremia. Temperature, PCT, and CRP all have lower sensitivity and specificity than IL-6. IL-6 ≥18.79pg/mL indicates the presence of pulmonary bacterial infection in newly diagnosed NHL patients, and IL-6 ≥102.6pg/mL may suggest pulmonary bacterial infection with bacteremia. In short, this study shows that cytokines can be advantageous in the diagnosis and differentiation of pulmonary bacterial infection and bacteremia in newly diagnosed NHL patients and may also guide for the use of clinical antibiotics.
非霍奇金淋巴瘤(NHL)是一种起源于淋巴组织的肿瘤。细菌感染在 NHL 患者中非常常见。由于大多数患者在感染的初始阶段没有明显症状,因此在病情恶化之前很难发现潜在的病情。细胞因子的激活是非炎症的标志。由于细胞因子检测时间短、灵敏度高的优点,许多研究都集中在细胞因子与感染之间的关系上。然而,针对感染 NHL 患者的研究却很少。因此,我们对 229 例新诊断的 NHL 患者和 40 例健康成年人的细胞因子谱进行了回顾性分析,以预测呼吸道细菌感染和菌血症。我们的研究结果表明,与无感染的 NHL 患者相比,发生呼吸道细菌感染的 NHL 患者的 IL-6(41.67 vs 9.50 pg/mL)、IL-8(15.55 vs 6.61 pg/mL)、IL-10(8.02 vs 4.52 pg/mL)、TNF-β(3.82 vs 2.96 pg/mL)、IFN-γ(4.76 vs 2.96 pg/mL)、体温(37.6 vs 36.5°C)、CRP(20.80 vs 4.37 mg/L)和 PCT(0.10 vs 0.04 ng/mL)水平显著升高(P<0.05)。此外,发生呼吸道感染性 NHL 且伴有更严重菌血症的患者的 IL-6(145.00 vs 41.67 pg/mL)、IL-8(34.60 vs 15.55 pg/mL)、体温(38.4 vs 37.6°C)、PCT(0.79 vs 0.10 ng/mL)和 CRP(93.70 vs 20.80 mg/L)水平显著升高(P<0.05)。值得注意的是,IL-6 和 IL-8 水平的升高有助于确定新发 NHL 患者是否患有肺部细菌性感染。体温、PCT 和 CRP 的敏感性和特异性均低于 IL-6。IL-6≥18.79pg/mL 表明新诊断的 NHL 患者存在肺部细菌性感染,IL-6≥102.6pg/mL 可能提示肺部细菌性感染伴菌血症。简而言之,本研究表明细胞因子在新发 NHL 患者肺部细菌性感染和菌血症的诊断和鉴别诊断中具有优势,也可能指导临床抗生素的使用。