CAJ | 학술논문

目的研究Castleman病(Castleman's disease,CD)患者IL-6的表达情况,并分析其临床病理学意义.方法收集92例CD患者标本,免疫组化法检测其IL-6的表达情况,并以20例淋巴结反应性增生(Lymph node reactive hyperplasia,LRH)患者标本作为对照组.结果 92例CD患者中男56例,女36例,中位年龄41(4 ～90)岁.其中多中心型(MCD)42例,单中心型(UCD) 50例；浆细胞型(PC-CD) 62例,透明血管型(HV-CD) 30例.所有患者HIV检测均阴性.92例CD患者中77例(83.7％) IL-6表达阳性,20例LRH患者仅1例(5.0％)表达阳性.各型CD患者中IL-6阳性表达率分别为:MCD 90.5％,UCD 78.0％;PC-CD 93.6％,HV-CD 63.4％,不同病理分型的阳性表达率差异有统计学意义(P =0.001).PC-CD组患者浆细胞高表达IL-6 (75.8％),MCD组患者浆细胞IL-6阳性率明显高于UCD组(P =0.003)；PC-CD组患者血管内皮细胞IL-6阳性率明显高于HV-CD组(P=0.008)；巨噬细胞和生发中心滤泡树突细胞的IL-6阳性率较低,分别为10.9％和3.3％.77例IL-6阳性患者中41例(53.2％)出现系统症状,而15例阴性患者中仅3例(20.0％)出现,差异有统计学意义(P =0.018).浆细胞和巨噬细胞表达IL-6阳性者出现系统症状的概率较阴性者显著增高(P值分别为0.007和0.039),浆细胞表达IL-6阳性者出现B症状的概率较阴性者明显增高(P=0.041).结论 IL-6在CD中有很高的表达率,与LRH不同.IL-6的表达与CD分型及系统症状密切相关.IL-6的检测对CD的诊断和治疗有重要的指导意义.
목적 연구Castleman병(Castleman's disease,CD)환자IL-6적표체정황,병분석기림상병이학의의.방법 수집92례CD환자표본,면역조화법검측기IL-6적표체정황,병이20례림파결반응성증생(Lymph node reactive hyperplasia,LRH)환자표본작위대조조.결과 92례CD환자중남56례,녀36례,중위년령41(4 ～90)세.기중다중심형(MCD)42례,단중심형(UCD) 50례；장세포형(PC-CD) 62례,투명혈관형(HV-CD) 30례.소유환자HIV검측균음성.92례CD환자중77례(83.7％) IL-6표체양성,20례LRH환자부1례(5.0％)표체양성.각형CD환자중IL-6양성표체솔분별위:MCD 90.5％,UCD 78.0％;PC-CD 93.6％,HV-CD 63.4％,불동병리분형적양성표체솔차이유통계학의의(P =0.001).PC-CD조환자장세포고표체IL-6 (75.8％),MCD조환자장세포IL-6양성솔명현고우UCD조(P =0.003)；PC-CD조환자혈관내피세포IL-6양성솔명현고우HV-CD조(P=0.008)；거서세포화생발중심려포수돌세포적IL-6양성솔교저,분별위10.9％화3.3％.77례IL-6양성환자중41례(53.2％)출현계통증상,이15례음성환자중부3례(20.0％)출현,차이유통계학의의(P =0.018).장세포화거서세포표체IL-6양성자출현계통증상적개솔교음성자현저증고(P치분별위0.007화0.039),장세포표체IL-6양성자출현B증상적개솔교음성자명현증고(P=0.041).결론 IL-6재CD중유흔고적표체솔,여LRH불동.IL-6적표체여CD분형급계통증상밀절상관.IL-6적검측대CD적진단화치료유중요적지도의의.
Objective To evaluate the expression of interleukin-6 (IL-6) and its clinicopathological significance in Castleman' s disease (CD).Methods Clinical data and paraffin blocks of 92 CD patients and 20 cases of lymph node reactive hyperplasia (LRH) as a control group were collected from department of pathology of Peking University Health Science Center.The expression of IL-6 was detected by using immunohistochemical method.Results The 92 patients were composed of 42 multicentric variant (MCDs) and 50unicentric variant (UCDs) clinically,and 30 hyaline-vascular variant (HV-CDs) and 62 plasma cell variant (PC-CDs) morphologically.None of them was positive for HIV tests.There were 56 males and 36 females,and their ages ranged from 4 years to 90 years with the median 41 years.IL-6 was expressed in 77 (83.7％)of 92 CD cases and 1 (5.0％) of 20 LRH cases.The expression rate of IL-6 was 90.5％ in MCDs,78.0％in UCDs,93.6％ in PC-CDs and 63.4％ in HV-CDs,respectively.PC-CD cases showed a significantly higher expression rate of IL-6 than HV-CD cases (P =0.001).All cases with positive IL-6 expression in plasmacytes were PC-CDs,showing obviously higher expression in MCDs than that in UCDs (P =0.003).Compared with HV-CD cases,much more PC-CD cases showed IL-6 positivity in endothelial cells (P =0.008).However,IL-6 was rarely expressed by both FDCs and macrophages,with only 3.3％ and 10.9％positive cases,respectively.There are 53.2％ (41/77) of the IL-6 positive cases and 20.0％ (3/15) of IL-6 negative cases suffered from systemic symptoms,showing a significant difference between the two groups (P=0.018).Cases with IL-6 expression in plasmacytes and macrophages were more likely to suffer from systemic symptoms,especially B type symptoms (P ＜ 0.05).Conclusions There is a high expression rate of IL-6 in CD,which is different from LRH.The expression of IL-6 has close relationship with CD subtypes and the presence of systemic symptoms.In all,the evaluation of interleukin-6 is of great value to guide the diagnosis and therapy of CD.