NHL患者血清IL-21的表达及临床意义
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摘要
目的检测非霍奇金淋巴瘤(NHL)患者血清中白细胞介素21(IL-21)的表达水平,探索IL-21与NHL的发病及预后的相关性。方法选择2015年12月至2016年12月遵义医学院附属医院收治的NHL患者36例(初诊患者20例,化疗后患者16例),以同期13例健康志愿者为对照组,应用酶联免疫吸附试验(ELISA)检测NHL患者治疗前后和对照组人群的血清IL-21水平,比较初诊NHL患者血清IL-21水平在年龄、性别、分期、分组、有无结外浸润等临床因素有无差异,分析治疗前后NHL患者血清IL-21水平的变化。结果 NHL患者血清IL-21水平为(200.75±58.91)ng/L,明显低于对照组的(420.91±132.56)ng/L,差异具有统计学意义(P<0.05);初诊NHL处于Ⅲ期和Ⅳ期患者血清IL-21水平为(153.77±25.97)ng/L,明显低于Ⅰ期和Ⅱ期患者的(223.87±35.36)ng/L,差异具有统计学意义(P<0.05);有全身症状者血清IL-21水平为(141.15±17.95)ng/L,明显低于无全身症状者的(208.46±33.50)ng/L,差异具有统计学意义(P<0.05);有结外浸润者血清IL-21水平为(143.94±19.38)ng/L,明显低于无结外浸润者的(212.53±32.80)ng/L,差异具有统计学意义(P<0.05);治疗前患者血清IL-21水平为(162.63±38.75)ng/L,明显低于治疗缓解后患者的(264.45±43.89)ng/L,差异具有统计学意义(P<0.05)。结论 IL-21表达水平与NHL的分期、分组、有无结外浸润有关,IL-21的表达水平可能与NHL的发病及预后有关。
Objective To investigate the expression and clinical significance of serum interleukin-21(IL-21)in patients with non-Hodgkin's lymphoma(NHL). Methods A total of 36 patients with NHL admitted to Department of Hematology of the Affiliated Hospital of Zunyi Medical University from December 2015 to December 2016 were selected as the research subjects, including 20 initially diagnosed patients and 16 patients after chemotherapy. Meantime, 13 healthy volunteers were enrolled as the control group. The levels of IL-21 in serum were determined by enzyme-linked immunosorbent assay(ELISA) to investigate its relationship with age, sex, stage, grouping, with or without internal and external organ infiltration and other clinical factors. The serum IL-21 levels changes in patients with NHL before and after chemotherapy were analyzed. Results The levels of IL-21 in NHL patients was lower than those in controls,(200.75±58.91) ng/L vs(420.91±132.56) ng/L, P<0.05. Compared with newly diagnosed NHL patients of stage Ⅰ andⅡ, the levels of IL-21 decreased markedly in patients of stage Ⅲ and Ⅳ,(153.77±25.97) ng/L vs(223.87±35.36) ng/L,P<0.05. The levels of IL-21 in patients with systemic symptoms were significantly lower than those without systemic symptoms,(141.15±17.95) ng/L vs(208.46±33.50) ng/L, P<0.05. Moreover, compared with infarcted organ infiltration group, the content of IL-21 declined significantly in extranodal organ infiltration group:(143.94±19.38) ng/L vs(212.53±32.80) ng/L, P<0.05. The serum IL-21 level in patients with NHL after treatment remission was significantly higher than that of NHL before treatment:(264.45±43.89) ng/L vs(162.63±38.75) ng/L, P<0.05. Conclusion The expression level of serum IL-21 is related to the staging, grouping and extranodal invasion of NHL. The level of serum IL-21 may be associated with the pathogenesis and prognosis of NHL.
Objective To investigate the expression and clinical significance of serum interleukin-21(IL-21)in patients with non-Hodgkin's lymphoma(NHL). Methods A total of 36 patients with NHL admitted to Department of Hematology of the Affiliated Hospital of Zunyi Medical University from December 2015 to December 2016 were selected as the research subjects, including 20 initially diagnosed patients and 16 patients after chemotherapy. Meantime, 13 healthy volunteers were enrolled as the control group. The levels of IL-21 in serum were determined by enzyme-linked immunosorbent assay(ELISA) to investigate its relationship with age, sex, stage, grouping, with or without internal and external organ infiltration and other clinical factors. The serum IL-21 levels changes in patients with NHL before and after chemotherapy were analyzed. Results The levels of IL-21 in NHL patients was lower than those in controls,(200.75±58.91) ng/L vs(420.91±132.56) ng/L, P<0.05. Compared with newly diagnosed NHL patients of stage Ⅰ andⅡ, the levels of IL-21 decreased markedly in patients of stage Ⅲ and Ⅳ,(153.77±25.97) ng/L vs(223.87±35.36) ng/L,P<0.05. The levels of IL-21 in patients with systemic symptoms were significantly lower than those without systemic symptoms,(141.15±17.95) ng/L vs(208.46±33.50) ng/L, P<0.05. Moreover, compared with infarcted organ infiltration group, the content of IL-21 declined significantly in extranodal organ infiltration group:(143.94±19.38) ng/L vs(212.53±32.80) ng/L, P<0.05. The serum IL-21 level in patients with NHL after treatment remission was significantly higher than that of NHL before treatment:(264.45±43.89) ng/L vs(162.63±38.75) ng/L, P<0.05. Conclusion The expression level of serum IL-21 is related to the staging, grouping and extranodal invasion of NHL. The level of serum IL-21 may be associated with the pathogenesis and prognosis of NHL.
引文
[1]陆滢,徐薇.异基因造血干细胞移植治疗非霍奇金淋巴瘤[J].现代实用医学,2016,28(12):1551-1553.
[2]Mcmichael EL,Jaimeramirez AC,Guenterberg K,et al.Interleukin-21 activates natural killer cell activity against cetuximab-coated pancreatic tumor cells[J].J Immunother Cancer,2015,3(S2):233.
[3]Xu M,Liu M,Du X,et al.Intratumoral delivery of IL-21 overcomes anti-her2/neu resistance through shifting tumor-associated macrophages from M2 to M1 phenotype[J].J Immunol,2015,194(10):4997-5006.
[4]Bhatia S,Curti B,Ernstoff MS,et al.Recombinant interleukin-21plus sorafenib formetastatic renal cell carcinoma:a phase 1/2 study[J].J Immunother Cancer,2014,2:2.
[5]刘艳,万岁桂.滤泡辅助性T细胞与自身免疫性疾病的研究进展[J].首都医科大学学报,2014,35(4):507-510.
[6]Parrish Novak J,Dillon SR,Nelson A,et al.Interleukin 21 and its receptor are involved in NK cell expansion and regulation of lymphocyte function[J].Nature,2000,408(6808):57-63.
[7]Habib T,Senadheera S,Weinberg K,et al.The common gamma chain(gamma c)is a required signaling component of the IL-21 receptor and supports IL-21-induced cell priferation via JAK3[J].Biochemistry,2002,41(27):8725-8731.
[8]Asao H,Okuyama C,Kumaki S,et al.Cutting Edge:The commonγ-chain is an indispensable subunit of the IL-21 receptor complex[J].J Immunol,2001,167(1):1-5.
[9]Bhatt S,Sarosiek KA,Lossos IS.Interleukin 21-its potential role in the therapy of B-cell lymphomas[J].Leuk Lymphoma,2017,58(1):17-29.
[10]覃建颖,曾建业.白细胞介素-21抗肿瘤作用研究进展[J].广西医学,2015,37(9):1309-1312.
[11]Cha Z,Gu H,Guo H,et al.Effect of interleukin 21 and its receptor on CD8+T cells in the pathogenesis of diffuse large B-cell lymphoma[J].Oncol Lett,2014,8(1):421-425.
[12]钟伟杰,李庆山,许昕,等.弥漫大B细胞淋巴瘤患者Th17细胞及相关细胞因子水平与预后的关系[J].广东医学,2016,37(5):674-677.
[13]刘红艳,叶松,冉昌丽,等.白介素-21对细胞毒T淋巴细胞杀伤非霍奇金淋巴瘤的影响[J].中国老年学杂志,2012,32(24):5448-5449.
[14]宋建新,朱红艳,沙玲.慢性粒细胞白血病患者血清IL-21水平检测的临床意义[J].国际检验医学杂志,2013,34(16):2103-2104.
[15]张振亚,许颖,张伟,等.结肠癌患者血清中IL-21水平分析及临床意义的研究[J].中国肿瘤临床,2009,36(18):1054-1056.
[16]王艳,赵颖海,王晓玫,等.鼻咽癌患者外周血T淋巴细胞及癌组织IL-21蛋白表达变化及意义[J].山东医药,2014,54(18):4-7.
[17]覃建颖,曾建业,叶宁,等.肺癌患者外周血及癌组织中白细胞介素-21+、CD8+、γ-干扰素+T细胞的变化及相互作用[J].中华实验外科杂志,2015,32(8):1779-1782.
[18]苏梅芳,王昌锋,赵咏梅,等.IL-17和IL-21在急性白血病患者中的表达及意义[J].中国实验血液学杂志,2010,18(5):1143-1146.
[19]Sarosiek KA,Malumbres R,Nechushtan H,et al.Novel IL-21 signaling pathway up-regulates c-Myc and induces apoptosis of diffuse large B-cell lymphomas[J].Blood,2010,115(3):570-580.
[20]Krejsa CM,Holly RD,Heipel M,et al.Interleukin-21 enhances rituximab activity in a cynomolgus monkey model of B cell depletion and in mouse B cell lymphoma models[J].PLo S One,2013,8(6):e67256.
[2]Mcmichael EL,Jaimeramirez AC,Guenterberg K,et al.Interleukin-21 activates natural killer cell activity against cetuximab-coated pancreatic tumor cells[J].J Immunother Cancer,2015,3(S2):233.
[3]Xu M,Liu M,Du X,et al.Intratumoral delivery of IL-21 overcomes anti-her2/neu resistance through shifting tumor-associated macrophages from M2 to M1 phenotype[J].J Immunol,2015,194(10):4997-5006.
[4]Bhatia S,Curti B,Ernstoff MS,et al.Recombinant interleukin-21plus sorafenib formetastatic renal cell carcinoma:a phase 1/2 study[J].J Immunother Cancer,2014,2:2.
[5]刘艳,万岁桂.滤泡辅助性T细胞与自身免疫性疾病的研究进展[J].首都医科大学学报,2014,35(4):507-510.
[6]Parrish Novak J,Dillon SR,Nelson A,et al.Interleukin 21 and its receptor are involved in NK cell expansion and regulation of lymphocyte function[J].Nature,2000,408(6808):57-63.
[7]Habib T,Senadheera S,Weinberg K,et al.The common gamma chain(gamma c)is a required signaling component of the IL-21 receptor and supports IL-21-induced cell priferation via JAK3[J].Biochemistry,2002,41(27):8725-8731.
[8]Asao H,Okuyama C,Kumaki S,et al.Cutting Edge:The commonγ-chain is an indispensable subunit of the IL-21 receptor complex[J].J Immunol,2001,167(1):1-5.
[9]Bhatt S,Sarosiek KA,Lossos IS.Interleukin 21-its potential role in the therapy of B-cell lymphomas[J].Leuk Lymphoma,2017,58(1):17-29.
[10]覃建颖,曾建业.白细胞介素-21抗肿瘤作用研究进展[J].广西医学,2015,37(9):1309-1312.
[11]Cha Z,Gu H,Guo H,et al.Effect of interleukin 21 and its receptor on CD8+T cells in the pathogenesis of diffuse large B-cell lymphoma[J].Oncol Lett,2014,8(1):421-425.
[12]钟伟杰,李庆山,许昕,等.弥漫大B细胞淋巴瘤患者Th17细胞及相关细胞因子水平与预后的关系[J].广东医学,2016,37(5):674-677.
[13]刘红艳,叶松,冉昌丽,等.白介素-21对细胞毒T淋巴细胞杀伤非霍奇金淋巴瘤的影响[J].中国老年学杂志,2012,32(24):5448-5449.
[14]宋建新,朱红艳,沙玲.慢性粒细胞白血病患者血清IL-21水平检测的临床意义[J].国际检验医学杂志,2013,34(16):2103-2104.
[15]张振亚,许颖,张伟,等.结肠癌患者血清中IL-21水平分析及临床意义的研究[J].中国肿瘤临床,2009,36(18):1054-1056.
[16]王艳,赵颖海,王晓玫,等.鼻咽癌患者外周血T淋巴细胞及癌组织IL-21蛋白表达变化及意义[J].山东医药,2014,54(18):4-7.
[17]覃建颖,曾建业,叶宁,等.肺癌患者外周血及癌组织中白细胞介素-21+、CD8+、γ-干扰素+T细胞的变化及相互作用[J].中华实验外科杂志,2015,32(8):1779-1782.
[18]苏梅芳,王昌锋,赵咏梅,等.IL-17和IL-21在急性白血病患者中的表达及意义[J].中国实验血液学杂志,2010,18(5):1143-1146.
[19]Sarosiek KA,Malumbres R,Nechushtan H,et al.Novel IL-21 signaling pathway up-regulates c-Myc and induces apoptosis of diffuse large B-cell lymphomas[J].Blood,2010,115(3):570-580.
[20]Krejsa CM,Holly RD,Heipel M,et al.Interleukin-21 enhances rituximab activity in a cynomolgus monkey model of B cell depletion and in mouse B cell lymphoma models[J].PLo S One,2013,8(6):e67256.