国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2014年
2期
102-105
,共4页
多发性骨髓瘤%受体,白介素6%预后
多髮性骨髓瘤%受體,白介素6%預後
다발성골수류%수체,백개소6%예후
Multiple myeloma%Receptor,interleukin-6%Prognosis
目的 研究血清可溶性白细胞介素-6受体(sIL-6R)与多发性骨髓瘤(MM)疗效及预后的关系,并探索其临床意义.方法 选择2006年7月至2011年12月,于首都医科大学附属北京朝阳医院血液科住院的67例初治为MM的患者为研究对象.按年龄将其分为:老年组(＞65岁,n=20)和年轻组(≤65岁,n=47);再按照Durie-Salmon(DS)分期标准将其分为:Ⅰ/Ⅱ期组(n=8)和Ⅲ期组(n=59);按照国际分期体系(ISS)分期标准将其分为:Ⅰ期组(n=6),Ⅱ期组(n=19)和Ⅲ期组(n=42);按照免疫分型标准将其分为:IgA型组(n=19),IgG型组(n=23),轻链型组(n=19)以及其他类型组(n=6);按照中位血清sIL-6R水平,将其分为sIL-6R≤500 ng/L组(n=43)和＞500 ng/L组(n=24).MM患者经4～6个疗程治疗后,能够评价疗效的患者为29例,按照疗效将其分为获得部分缓解(PR)及以上疗效组(n=25)和未达PR组(n=4).(本研究遵循的程序符合首都医科大学附属北京朝阳医院人体试验委员会所制定的伦理学标准,分组征得受试对象本人的知情同意,并与之签订临床研究知情同意书).采用酶联免疫吸附法(ELISA)检测患者血清sIL-6R水平上,比较其在不同年龄组、不同免疫分型组、不同临床分期组患者中的表达,并分析血清sIL-6R水平与患者疗效以及生存之间的关系.结果 老年组MM患者的血清sIL-R6水平为(496.6±204.4)ng/L与年轻组的(494.8±260.0)ng/L相近,两组比较差异无统计学意义(t=0.027,P=0.98);IgG型患者的sIL-6R水平最高[(590.6±285.5) ng/L],轻链型患者次之[(475.6±253.0) ng/L],lgA型患者最低[(418.0±137.1) ng/L],但3组比较差异无统计学意义(F=2.895,P＞0.05).DS分期Ⅰ/Ⅱ患者的sIL-6R水平为(598.1±347.2)ng/L较Ⅲ期组的(482.3±226.5)ng/L高,但两组间差异无统计学(t=1.199,P=0.23).ISS分期Ⅰ期组患者sIL-6R水平为(469.5±271.4)ng/L较Ⅱ期组[(510.9±239.9)]ng/L和Ⅲ期组[(492.1±146.4)]ng/L低,但3组相比差异无统计学意义(F=0.074,P＞0.05).MM患者接受治疗后,获得部分缓解(PR)及以上疗效组患者的sIL-6R水平较治疗前降低(t=1.759,P=0.08),未获得PR疗效患者的sIL-6R水平较治疗前有所升高(t=0.285,P=0.78).sIL-6R水平≤500 ng/L患者的中位生存期较＞500 ng/L组患者长(32.3个月比19.6个月),但两组相比差异无统计学意义(P=0.18).结论 MM患者的sIL-6R水平与患者年龄、分期和分型的关系不明确,但与疗效和生存预后有一定关系.
目的 研究血清可溶性白細胞介素-6受體(sIL-6R)與多髮性骨髓瘤(MM)療效及預後的關繫,併探索其臨床意義.方法 選擇2006年7月至2011年12月,于首都醫科大學附屬北京朝暘醫院血液科住院的67例初治為MM的患者為研究對象.按年齡將其分為:老年組(＞65歲,n=20)和年輕組(≤65歲,n=47);再按照Durie-Salmon(DS)分期標準將其分為:Ⅰ/Ⅱ期組(n=8)和Ⅲ期組(n=59);按照國際分期體繫(ISS)分期標準將其分為:Ⅰ期組(n=6),Ⅱ期組(n=19)和Ⅲ期組(n=42);按照免疫分型標準將其分為:IgA型組(n=19),IgG型組(n=23),輕鏈型組(n=19)以及其他類型組(n=6);按照中位血清sIL-6R水平,將其分為sIL-6R≤500 ng/L組(n=43)和＞500 ng/L組(n=24).MM患者經4～6箇療程治療後,能夠評價療效的患者為29例,按照療效將其分為穫得部分緩解(PR)及以上療效組(n=25)和未達PR組(n=4).(本研究遵循的程序符閤首都醫科大學附屬北京朝暘醫院人體試驗委員會所製定的倫理學標準,分組徵得受試對象本人的知情同意,併與之籤訂臨床研究知情同意書).採用酶聯免疫吸附法(ELISA)檢測患者血清sIL-6R水平上,比較其在不同年齡組、不同免疫分型組、不同臨床分期組患者中的錶達,併分析血清sIL-6R水平與患者療效以及生存之間的關繫.結果 老年組MM患者的血清sIL-R6水平為(496.6±204.4)ng/L與年輕組的(494.8±260.0)ng/L相近,兩組比較差異無統計學意義(t=0.027,P=0.98);IgG型患者的sIL-6R水平最高[(590.6±285.5) ng/L],輕鏈型患者次之[(475.6±253.0) ng/L],lgA型患者最低[(418.0±137.1) ng/L],但3組比較差異無統計學意義(F=2.895,P＞0.05).DS分期Ⅰ/Ⅱ患者的sIL-6R水平為(598.1±347.2)ng/L較Ⅲ期組的(482.3±226.5)ng/L高,但兩組間差異無統計學(t=1.199,P=0.23).ISS分期Ⅰ期組患者sIL-6R水平為(469.5±271.4)ng/L較Ⅱ期組[(510.9±239.9)]ng/L和Ⅲ期組[(492.1±146.4)]ng/L低,但3組相比差異無統計學意義(F=0.074,P＞0.05).MM患者接受治療後,穫得部分緩解(PR)及以上療效組患者的sIL-6R水平較治療前降低(t=1.759,P=0.08),未穫得PR療效患者的sIL-6R水平較治療前有所升高(t=0.285,P=0.78).sIL-6R水平≤500 ng/L患者的中位生存期較＞500 ng/L組患者長(32.3箇月比19.6箇月),但兩組相比差異無統計學意義(P=0.18).結論 MM患者的sIL-6R水平與患者年齡、分期和分型的關繫不明確,但與療效和生存預後有一定關繫.
목적 연구혈청가용성백세포개소-6수체(sIL-6R)여다발성골수류(MM)료효급예후적관계,병탐색기림상의의.방법 선택2006년7월지2011년12월,우수도의과대학부속북경조양의원혈액과주원적67례초치위MM적환자위연구대상.안년령장기분위:노년조(＞65세,n=20)화년경조(≤65세,n=47);재안조Durie-Salmon(DS)분기표준장기분위:Ⅰ/Ⅱ기조(n=8)화Ⅲ기조(n=59);안조국제분기체계(ISS)분기표준장기분위:Ⅰ기조(n=6),Ⅱ기조(n=19)화Ⅲ기조(n=42);안조면역분형표준장기분위:IgA형조(n=19),IgG형조(n=23),경련형조(n=19)이급기타류형조(n=6);안조중위혈청sIL-6R수평,장기분위sIL-6R≤500 ng/L조(n=43)화＞500 ng/L조(n=24).MM환자경4～6개료정치료후,능구평개료효적환자위29례,안조료효장기분위획득부분완해(PR)급이상료효조(n=25)화미체PR조(n=4).(본연구준순적정서부합수도의과대학부속북경조양의원인체시험위원회소제정적윤리학표준,분조정득수시대상본인적지정동의,병여지첨정림상연구지정동의서).채용매련면역흡부법(ELISA)검측환자혈청sIL-6R수평상,비교기재불동년령조、불동면역분형조、불동림상분기조환자중적표체,병분석혈청sIL-6R수평여환자료효이급생존지간적관계.결과 노년조MM환자적혈청sIL-R6수평위(496.6±204.4)ng/L여년경조적(494.8±260.0)ng/L상근,량조비교차이무통계학의의(t=0.027,P=0.98);IgG형환자적sIL-6R수평최고[(590.6±285.5) ng/L],경련형환자차지[(475.6±253.0) ng/L],lgA형환자최저[(418.0±137.1) ng/L],단3조비교차이무통계학의의(F=2.895,P＞0.05).DS분기Ⅰ/Ⅱ환자적sIL-6R수평위(598.1±347.2)ng/L교Ⅲ기조적(482.3±226.5)ng/L고,단량조간차이무통계학(t=1.199,P=0.23).ISS분기Ⅰ기조환자sIL-6R수평위(469.5±271.4)ng/L교Ⅱ기조[(510.9±239.9)]ng/L화Ⅲ기조[(492.1±146.4)]ng/L저,단3조상비차이무통계학의의(F=0.074,P＞0.05).MM환자접수치료후,획득부분완해(PR)급이상료효조환자적sIL-6R수평교치료전강저(t=1.759,P=0.08),미획득PR료효환자적sIL-6R수평교치료전유소승고(t=0.285,P=0.78).sIL-6R수평≤500 ng/L환자적중위생존기교＞500 ng/L조환자장(32.3개월비19.6개월),단량조상비차이무통계학의의(P=0.18).결론 MM환자적sIL-6R수평여환자년령、분기화분형적관계불명학,단여료효화생존예후유일정관계.
Objective To study the relationship between serum soluble interleukin 6 receptor (sIL-6R) and treatment efficacy and prognosis of multiple myeloma (MM),and explore its clinical significance of sIL-6R.Methods Form July 2006 to December 2011,67 MM patients who received treatment in Beijing Chaoyang hospital,Capital Medical University were selected into this study.According to age of patents,they were divided into the older group (＞65 years old,n=20) and young group (≤65 years old,n=47).According to Durie-Salmon (DS) staging criteria,the patients were divided into DS Ⅰ/Ⅱ stage group (n=8) and Ⅲ stage group (n=59).According to the International Staging system (ISS) criteria,the patients were divided into ISS Ⅰ stage group (n 6),stage Ⅱ stage group (n 19) and Ⅲ stage group (n=42).According to the immune classification criteria,the patients were divided into IgA group (n=19),IgG group (n=23),light chain group (n=19) and other types group (n 6).According to the median serum sIL-6R levels of patients,they were divided into sIL-6R≤500 ng/ L group (n 43) and ＞500 ng/L group (n 24).After four to six courses of treatment,there were 29 cases of MM patients could evaluate the efficacy.According to the efficacy of patients,they were divided into ≥partial remission (PR) group (n 25)and ＜PR group (n=4).(The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Beijing Chaoyang hospital.Informed consent was obtained from all participants.) The serum levels of sIL-6R were detected by enzyme-linked immunosorbent assay technique in 67 patients with MM.The serum sIL-6R levels of MM patients in different ages,immunophenotypes and clinical stages were compared.The relationship between serum levels of sIL-6R between patient outcomes and survival were analyzed.Results sIL-6R levels of MM patients in older group were (496.6±204.4) ng/L,which were similar with the young group[(494.8±260.0) ng/L)] (t=0.027,P=0.98).Patients in IgA type group had lower sIL-6R levels [(418.0±137.1) ng/L] than those of IgG type group [(590.6±285.5) ng/L] and light chain type group [(475.6±253.0) ng/L],but there were no statistical significance among these three groups (F=2.895,P＞0.05).Patients with DS stage Ⅰ/Ⅱ had higher sIL-6R levels [(598.1± 347.2) ng/L] than those of stage Ⅲ [(482.3±226.5) ng/L],and it also had no statistical significance (t=1.199,P＞0.05).Patients with ISS stage Ⅰ had lower sIL-6R levels [(469.5±271.4) ng/L] than those of stage Ⅱ [(510.9±239.9) ng/L] and stage Ⅲ [(492.1 ± 146.4) ng/L],and it also had no statistical significance (F 0.074,P＞0.05).After treatment,patients who obtained PR or more had decrease of sIL-6R levels (t=1.759,P=0.08),patients who obtained less than PR had increase of sIL-6R levels (t =0.285,P=0.78).Patients with sIL-6R ≤500 ng/L had longer overall survival time than those of ＞ 500 ng/L (32.3 months vs.19.6 months),however their had no statistical significance (P=0.18).Conclusions Serum sIL-6R levels of MM patients had no association with age,clinical stages and immunophenotype.There maybe a certain relationship among sIL 6R levels of MM patients,efficacy and survival prognosis.
