Vonderheid E C, Zhang Q, Lessin S R, Polansky M, Abrams J T, Bigler R D, Wasik M A
Department of Dermatology, School of Public Health, Allegheny University of the Health Sciences, Philadelphia, PA 19102, USA.
J Am Acad Dermatol. 1998 Feb;38(2 Pt 1):207-20. doi: 10.1016/s0190-9622(98)70597-3.
The serum concentration of soluble alpha chain of the interleukin-2 receptor (sIL-2R) correlates with tumor burden in cutaneous T-cell lymphoma (CTCL). Therefore the sIL-2R level may be useful to monitor the condition of patients treated with extracorporeal photopheresis or other treatments.
Our goal was to determine the utility of serum sIL-2R as a test in monitoring of patients with advanced CTCL.
Serum sIL-2R was measured serially in 36 patients with advanced CTCL treated with extracorporeal photopheresis and other modalities (interferon alfa, methotrexate, topical nitrogen mustard, electron beam).
Serum concentrations of sIL-2R as well as lactate dehydrogenase (LDH) correlated strongly with lymph node size, but only sIL-2R correlated significantly with the severity of skin manifestations in erythrodermic patients. In addition, serum sIL-2R, but not LDH, was significantly higher in patients with nodal involvement. The level of sIL-2R also was significantly higher in patients with large-cell transformation in the skin or lymph nodes compared with patients without transformed disease. During treatment, serum concentrations of both serum sIL-2R and LDH correlated with changes in clinical status, but only sIL-2R showed statistically significant differences in mean levels for different relative global response scores. Pretreatment levels of both sIL-2R and LDH correlated significantly with survival, but only sIL-2R retained significance when both were entered into the Cox proportionate hazards model.
The concentration of serum sIL-2R correlates well with disease status and is more useful than LDH or Sézary cell counts to monitor clinical change in patients with advanced CTCL. Moreover, our data suggest that sIL-2R is produced at a relatively low rate by tissue-based lymphoma cells, and that large-cell transformation in CTCL results in marked increase in sIL-2R production in some patients.
白细胞介素-2受体可溶性α链（sIL-2R）的血清浓度与皮肤T细胞淋巴瘤（CTCL）的肿瘤负荷相关。因此，sIL-2R水平可能有助于监测接受体外光化学疗法或其他治疗的患者的病情。
我们的目标是确定血清sIL-2R作为监测晚期CTCL患者的一项检测指标的效用。
对36例接受体外光化学疗法及其他治疗方式（α干扰素、甲氨蝶呤、局部氮芥、电子束）的晚期CTCL患者进行血清sIL-2R的连续检测。
sIL-2R以及乳酸脱氢酶（LDH）的血清浓度与淋巴结大小密切相关，但仅sIL-2R与红皮病患者皮肤表现的严重程度显著相关。此外，有淋巴结受累的患者血清sIL-2R显著升高，而LDH无此现象。皮肤或淋巴结发生大细胞转化的患者与未发生转化疾病的患者相比，sIL-2R水平也显著更高。在治疗期间，血清sIL-2R和LDH的浓度均与临床状态变化相关，但只有sIL-2R在不同相对总体反应评分的平均水平上显示出统计学显著差异。sIL-2R和LDH的治疗前水平均与生存率显著相关，但当两者都纳入Cox比例风险模型时只有sIL-2R仍具有显著性。
血清sIL-2R浓度与疾病状态密切相关，在监测晚期CTCL患者的临床变化方面比LDH或Sezary细胞计数更有用。此外，我们的数据表明基于组织的淋巴瘤细胞产生sIL-2R的速率相对较低，并且CTCL中的大细胞转化导致一些患者的sIL-2R产生显著增加。
