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血清 sCD25/铁蛋白比值联合 MCP-1 是鉴别以 HLH 为首发表现的 LAHS 的有效预测指标。

Serum sCD25/ferritin ratio combined with MCP-1 is a valid predictor for identifying LAHS with HLH as the first manifestation.

机构信息

Department of Hematology, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China.

Department of General Practice, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China.

出版信息

J Cancer Res Clin Oncol. 2023 Sep;149(11):8521-8533. doi: 10.1007/s00432-023-04781-4. Epub 2023 Apr 24.

Abstract

PURPOSE

Lymphoma-associated haemophagocytic syndrome (LAHS) is a group of malignant diseases with rapid progression and a high mortality rate. Our study aimed to discover the significance of serum sCD25/ferritin ratio as well as cytokines in assisting the diagnosis of LAHS.

METHODS

We retrospectively analyzed the clinical data of 82 patients with LAHS with hemophagocytic lymphohistiocytosis (HLH) as the first manifestation and divided them into B-LAHS group and T/NK-LAHS group according to lymphoma pathological diagnosis for comparison. And patients with LAHS were divided into responding group, non-responding group according to the assessment of efficacy after receiving DEP/L-DEP induction therapy for 2 weeks to compare possible valuable indicators.

RESULTS

Serum sCD25/ferritin ratio and MCP-1 levels were significantly different between B-LAHS and T/NK-LAHS groups (P = 0.001, P = 0.022). An sCD25/ferritin ratio > 7.8 tended to suggest a diagnosis of B-LAHS (AUC = 0.71, 95% CI: 0.596-0.823), and the sCD25/ferritin ratio had better predictive value when combined with MCP-1 (AUC = 0.81, 95% CI: 0.699-0.922). The sCD25/ferritin ratio was also significantly different between the two groups responding or not responding to induction therapy (P = 0.002), yielding an optimal cutoff value of 11.48. An sCD25/ferritin ratio > 11.48 tended to suggest that the patient's LAHS was responsive to induction therapy.

CONCLUSION

Our study reveals that serum sCD25/ferritin ratio combined with MCP-1 is a valid predictor for identifying LAHS with HLH as the first manifestation and may assist in predicting whether the lymphoma is of B-cell or T/NK-cell origin. The sCD25/ferritin ratio can also be used to predict the early response of LAHS after induction therapy.

摘要

目的

噬血细胞性淋巴组织细胞增生症(LAHS)是一组恶性疾病,具有进展迅速和高死亡率的特点。本研究旨在探讨血清可溶性 CD25/铁蛋白比值(sCD25/ferritin ratio)及细胞因子在辅助诊断 LAHS 中的意义。

方法

回顾性分析 82 例以噬血细胞性淋巴组织细胞增生症(HLH)为首发表现的 LAHS 患者的临床资料,根据淋巴瘤病理诊断分为 B-LAHS 组和 T/NK-LAHS 组进行比较,并根据 DEP/L-DEP 诱导治疗 2 周后疗效评估将 LAHS 患者分为缓解组和未缓解组,比较可能有价值的指标。

结果

B-LAHS 组和 T/NK-LAHS 组患者血清 sCD25/铁蛋白比值和 MCP-1 水平差异有统计学意义(P=0.001,P=0.022)。sCD25/ferritin ratio>7.8 倾向于提示 B-LAHS 的诊断(AUC=0.71,95%CI:0.596-0.823),sCD25/ferritin ratio 联合 MCP-1 具有更好的预测价值(AUC=0.81,95%CI:0.699-0.922)。诱导治疗缓解组和未缓解组患者 sCD25/ferritin ratio 差异有统计学意义(P=0.002),最佳截断值为 11.48。sCD25/ferritin ratio>11.48 倾向于提示 LAHS 对诱导治疗有反应。

结论

本研究表明,血清 sCD25/ferritin ratio 联合 MCP-1 可有效预测以 HLH 为首发表现的 LAHS,有助于预测淋巴瘤起源于 B 细胞还是 T/NK 细胞。sCD25/ferritin ratio 还可用于预测 LAHS 诱导治疗后的早期反应。

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