Viviani S, Camerini E, Bonfante V, Santoro A, Balzarotti M, Fornier M, Devizzi L, Verderio P, Valagussa P, Bonadonna G
Division of Medical Oncology A, Istituto Nazionale Tumori, Milano, Italy.
Br J Cancer. 1998 Mar;77(6):992-7. doi: 10.1038/bjc.1998.163.
The aim of this study was to assess the prognostic role of soluble interleukin-2 receptors (sIL-2R) in Hodgkin's disease (HD) both in the achievement of complete remission (CR) and in predicting disease relapse. Between August 1988 and June 1993 sIL-2R serum levels were measured in 174 untreated patients; in 137 of them evaluation was repeated at the end of treatment and in 132 also during the follow-up. Baseline sIL-2R levels (mean+/-standard error) were significantly higher in patients than in 65 healthy control subjects (1842+/-129 U ml(-1) vs 420+/-10 U ml(-10, P< 0.0001). At the end of treatment 135 out of 137 evaluated patients achieved complete response (CR) and their mean sIL-2R serum levels were significantly lower than those at diagnosis (635+/-19 U ml(-1) vs 1795+/-122 U ml(-1), P=0.0001). After a median follow-up of 5 years, sIL-2R remained low in 114 patients in continuous CR, while they increased in 9 out of 12 patients (75%) who relapsed. However, a temporary increase was also observed in six patients (5%) still in CR. Treatment outcome in terms of freedom from progression was linearly related to sIL-2R levels. Our study confirms that patients with untreated HD have increased baseline levels of sIL-2R compared with healthy subjects and that their pretreatment values may be an indication of disease outcome similar to other conventional prognostic factors, such as number of involved sites, presence of B symptoms and extranodal extent.
本研究旨在评估可溶性白细胞介素-2受体(sIL-2R)在霍奇金淋巴瘤(HD)实现完全缓解(CR)及预测疾病复发方面的预后作用。1988年8月至1993年6月期间,对174例未经治疗的患者测定了血清sIL-2R水平;其中137例在治疗结束时重复进行了评估,132例在随访期间也进行了评估。患者的基线sIL-2R水平(均值±标准误)显著高于65名健康对照者(1842±129 U/ml vs 420±10 U/ml,P<0.0001)。治疗结束时,137例接受评估的患者中有135例达到完全缓解(CR),其平均血清sIL-2R水平显著低于诊断时(635±19 U/ml vs 1795±122 U/ml,P=0.0001)。经过5年的中位随访,114例持续CR的患者sIL-2R仍保持较低水平,而12例复发患者中有9例(75%)sIL-2R水平升高。然而,仍处于CR的6例患者(5%)也出现了sIL-2R的暂时升高。无进展生存期方面的治疗结果与sIL-2R水平呈线性相关。我们的研究证实,未经治疗的HD患者与健康受试者相比基线sIL-2R水平升高,其治疗前的值可能与其他传统预后因素(如受累部位数量、B症状的存在及结外侵犯范围)类似,可作为疾病预后的一个指标。