DuVillard L, Guiguet M, Casasnovas R O, Caillot D, Monnier-Zeller V, Bernard A, Guy H, Solary E
Laboratory of Biochemistry, C.H.U. Le Bocage, Dijon, France.
Br J Haematol. 1995 Feb;89(2):243-9. doi: 10.1111/j.1365-2141.1995.tb03296.x.
The serum level of IL-6 was reported to reflect disease severity in patients with multiple myeloma. We used a specific radioimmunoassay to measure the level of IL-6 in 239 serum samples in which a monoclonal gammopathy was identified for the first time. The same sample was used for the measurement of serum C reactive protein and serum albumin. Then, an inventory of clinical and biological features allowed us to classify these patients into five groups: monoclonal gammopathy of undetermined significance (MGUS:128), multiple myeloma (MM:66), Waldenström's macroglobulinaemia (WM:27), non-Hodgkin's lymphoma (NHL:11) and chronic lymphocytic leukaemia (CLL:7). The number of patients with serum IL-6 (S-IL-6) level > 0.335 ng/ml (upper limit in normal sera) was significantly higher in the MM group (35%; Confidence Interval (CI) 23.5-46.5) compared with the MGUS group (15%; CI 8.8-21.2). The distribution of S-IL-6 levels was also significantly different between the groups (Mann-Whitney test: P < 0.01). High S-IL-6 levels were measured in 5/11 patients with NHL and 9/27 patients with WM. The distribution of S-IL-6 levels in these groups was the same as that in MGUS or MM groups. In patients with MM, elevated S-IL-6 levels were associated with haemoglobin level < 100 g/l (P < 0.005), bone marrow plasmocytosis > 50% (P < 0.005) and stages II and III in the Durie & Salmon staging system (P < 0.005). The S-IL-6 level was also related to light chain component excretion in urine (P < 0.01) and M component serum level for IgA (P < 0.01). In patients with MGUS, the S-IL-6 level correlated with serum CRP level (P < 0.05), serum lactate dehydrogenase (P < 0.05) and serum ferritin (P < 0.01). We conclude that the S-IL-6 level is a marker of high tumour burden in multiple myeloma. However, S-IL-6 level can be increased in patients with MGUS in relation to inflammatory parameters. Therefore the S-IL-6 level does not demonstrate high predictive value for the diagnosis of MM in patients with newly identified monoclonal gammopathy.
据报道，白细胞介素-6（IL-6）的血清水平可反映多发性骨髓瘤患者的疾病严重程度。我们采用特异性放射免疫分析法，对首次确诊为单克隆丙种球蛋白病的239份血清样本中的IL-6水平进行了检测。同一血清样本还用于检测血清C反应蛋白和血清白蛋白水平。随后，根据临床和生物学特征清单，我们将这些患者分为五组：意义未明的单克隆丙种球蛋白病（MGUS：128例）、多发性骨髓瘤（MM：66例）、华氏巨球蛋白血症（WM：27例）、非霍奇金淋巴瘤（NHL：11例）和慢性淋巴细胞白血病（CLL：7例）。与MGUS组（15%；置信区间（CI）8.8 - 21.2）相比，MM组血清IL-6（S-IL-6）水平>0.335 ng/ml（正常血清上限）的患者数量显著更高（35%；CI 23.5 - 46.5）。各组间S-IL-6水平分布也存在显著差异（曼-惠特尼检验：P < 0.01）。在11例NHL患者中有5例、27例WM患者中有9例检测到高S-IL-6水平。这些组中S-IL-6水平分布与MGUS组或MM组相同。在MM患者中，S-IL-6水平升高与血红蛋白水平<100 g/l（P < 0.005）、骨髓浆细胞增多>50%（P < 0.005）以及Durie & Salmon分期系统中的II期和III期相关（P < 0.005）。S-IL-6水平还与尿轻链成分排泄相关（P < 0.01）以及IgA的M成分血清水平相关（P < 0.01）。在MGUS患者中，S-IL-6水平与血清CRP水平（P < 0.05）、血清乳酸脱氢酶（P < 0.05）和血清铁蛋白（P < 0.01）相关。我们得出结论，S-IL-6水平是多发性骨髓瘤高肿瘤负荷的一个标志物。然而，MGUS患者的S-IL-6水平可能因炎症参数而升高。因此，对于新确诊的单克隆丙种球蛋白病患者，S-IL-6水平对MM诊断的预测价值不高。
