Bian Haiyan, Wang Lisheng, Gao Chengwen, Liu Zhihe, Sun Yang, Hu Minghui, Xiao Yujing, Hao Fengyun, Ma Yushuo, Zhao Xia
Department of Hematology, the Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
Laboratory of Molecular Diagnosis and Regenerative Medicine, the Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China.
J Inflamm Res. 2022 Jul 7;15:3815-3828. doi: 10.2147/JIR.S366761. eCollection 2022.
Primary central nervous system lymphoma (PCNSL) responds favorably to radiation, chemotherapy and targeted drug therapy. However survival is usually worse, the treatment-related drug resistance and recurrence are still clinical problems to be solved urgently. Studies have shown that cytokines are expressed in varying degrees in patients with lymphoma, which is significantly related to the progression, poor prognosis and drug resistance of lymphoma. We explore the expression and clinical significance of Th1/Th2/Th17 cytokines and lymphocyte subsets in patients with PCNSL to provide a more sufficient theoretical basis for its diagnosis and treatment.
We measured and analysed the levels of Th1/Th2/Th17 cytokines and the distribution of lymphocyte subsets (including Treg cells, CD3+, CD4+, CD8+, CD19+, and CD4+/CD8+) in 39 patients with PCNSL and 96 patients with diffuse large B-cell lymphoma (DLBCL) without central nervous system involvement. The cytokines of 13 healthy people and the lymphocyte subsets of 27 healthy people were measured as the control group.
We found a significant difference in the level of Th1/Th2/Th17 cytokines and lymphocyte subsets between PCNSL and healthy controls, especially IL-2, after treatment, which was significantly higher than before treatment (<0.01). However, the level of CD19+ and CD4+/CD8+ decreased while CD8+ and CD3+ increased after treatment (regardless of whether the treatment was effective), and the difference was statistically significant. In addition, our analysis of different prognostic factors found that HD-MTX-based chemotherapy appears to have a longer progression-free survival and overall survival than osimertinib-based chemotherapy.
There are significant differences in Th1/Th2/Th17 cytokines and lymphocyte subsets among PCNSL, DLBCL, and healthy controls, and their detection is helpful for the diagnosis, treatment, and prognosis of PCNSL. HD-MTX-based chemotherapy may still be the first choice for PCNSL.
原发性中枢神经系统淋巴瘤（PCNSL）对放疗、化疗及靶向药物治疗反应良好。然而，其生存率通常较差，治疗相关的耐药性和复发仍是亟待解决的临床问题。研究表明，细胞因子在淋巴瘤患者中存在不同程度的表达，这与淋巴瘤的进展、预后不良及耐药性显著相关。我们探讨PCNSL患者中Th1/Th2/Th17细胞因子及淋巴细胞亚群的表达及临床意义，为其诊断和治疗提供更充分的理论依据。
我们检测并分析了39例PCNSL患者及96例无中枢神经系统受累的弥漫性大B细胞淋巴瘤（DLBCL）患者的Th1/Th2/Th17细胞因子水平及淋巴细胞亚群（包括调节性T细胞、CD3 +、CD4 +、CD8 +、CD19 +及CD4 +/CD8 +）的分布情况。将13名健康人的细胞因子及27名健康人的淋巴细胞亚群作为对照组进行检测。
我们发现PCNSL患者与健康对照组之间Th1/Th2/Th17细胞因子水平及淋巴细胞亚群存在显著差异，尤其是治疗后的白细胞介素-2，显著高于治疗前（<0.0l）。然而，治疗后CD19 +及CD4 +/CD8 +水平降低，而CD8 +及CD3 +升高（无论治疗是否有效），差异具有统计学意义。此外，我们对不同预后因素的分析发现，基于大剂量甲氨蝶呤（HD-MTX）的化疗似乎比基于奥希替尼的化疗具有更长的无进展生存期和总生存期。
PCNSL、DLBCL及健康对照组之间Th1/Th2/Th17细胞因子及淋巴细胞亚群存在显著差异，其检测有助于PCNSL的诊断、治疗及预后评估。基于HD-MTX的化疗可能仍是PCNSL的首选治疗方法。
