Stasi R, Brunetti M, Parma A, Di Giulio C, Terzoli E, Pagano A
Department of Medical Sciences, Regina Apostolorum Hospital, Albano Laziale, Italy.
Cancer. 1998 May 15;82(10):1860-6.
The effect of interleukin-6 (IL-6), the major growth factor for myeloma cells, may be enhanced by soluble IL-6 receptor (sIL-6R). Therefore, the current study investigated the clinical significance of serum sIL-6R in patients with multiple myeloma (MM).
Serum levels of sIL-6R were determined by enzyme-linked immunoassay in 55 normal controls, 81 individuals with monoclonal gammopathy of undetermined significance (MGUS), and 164 patients with MM in various phases of the disease.
sIL-6R concentrations were higher in MM patients (162.0 +/- 134.6 ng/mL) than in individuals with MGUS (58.9 +/- 36.7 ng/mL) or in controls (45.6 +/- 22.3 ng/mL) (P = 0.0000). sIL-6R was not found to have a significant linear correlation with any other parameter, including IL-6, beta2-microglobulin (beta2-m), and neopterin, either in newly diagnosed cases or during the course of the disease. In addition, there were no statistically significant differences in sIL-6R concentrations between the clinical stages at the time of diagnosis. In univariate logistic regression analysis sIL-6R was a significant but weak prognostic indicator (P = 0.000000). Kaplan-Meier analysis showed that elevated levels of sIL-6R were associated with shorter survival (P = 0.00282). Patients also were stratified according to their serum beta2-m and sIL-6R levels. Patients with low levels of both parameters had a clear survival benefit over the other groups (P = 0.000000).
The correlation between sIL-6R levels and survival is significant but weak, making it unlikely to be of much value in predicting the outcome of patients with MM alone. The results of the current study support the role of sIL-6R levels in improving the prognostic value of beta2-m and in discriminating patients with MM from individuals with MGUS.
白细胞介素-6（IL-6）是骨髓瘤细胞的主要生长因子，其作用可能会被可溶性IL-6受体（sIL-6R）增强。因此，本研究调查了血清sIL-6R在多发性骨髓瘤（MM）患者中的临床意义。
采用酶联免疫吸附测定法测定了55名正常对照者、81名意义未明的单克隆丙种球蛋白病（MGUS）患者和164例处于疾病不同阶段的MM患者的血清sIL-6R水平。
MM患者的sIL-6R浓度（162.0±134.6 ng/mL）高于MGUS患者（58.9±36.7 ng/mL）或对照者（45.6±22.3 ng/mL）（P = 0.0000）。无论是在新诊断病例还是在疾病过程中，均未发现sIL-6R与任何其他参数（包括IL-6、β2-微球蛋白（β2-m）和新蝶呤）有显著的线性相关性。此外，诊断时各临床分期之间的sIL-6R浓度无统计学显著差异。在单因素逻辑回归分析中，sIL-6R是一个显著但较弱的预后指标（P = 0.000000）。Kaplan-Meier分析表明，sIL-6R水平升高与生存期缩短相关（P = 0.00282）。患者还根据其血清β2-m和sIL-6R水平进行分层。两个参数水平均低的患者比其他组有明显的生存优势（P = 0.000000）。
sIL-6R水平与生存之间的相关性显著但较弱，这使得它不太可能单独在预测MM患者的预后方面有太大价值。本研究结果支持sIL-6R水平在提高β2-m的预后价值以及区分MM患者与MGUS患者方面的作用。
