Serum interleukin 6 levels are elevated in lymphoma patients and correlate with survival in advanced Hodgkin's disease and with B symptoms.
Serum interleukin 6 levels are elevated in lymphoma patients and correlate with survival in advanced Hodgkin's disease and with B symptoms.
复制标题
淋巴瘤患者的血清白细胞介素 6 水平升高，与晚期霍奇金病的生存率和 B 症状相关。
作者：
R. Kurzrock;J. Redman;F. Cabanillas;Donnah Jones;J. Rothberg;Moshe Talpaz
包括γ-干扰素、肿瘤坏死因子α、白细胞介素1 β（IL-1 β）和白细胞介素6（IL-6）在内的几种细胞因子具有致热原性，可抑制脂肪生成过程。由于淋巴瘤患者常伴有发热、体重减轻和盗汗（B症状），其病因尚不清楚，因此作者研究了正常志愿者以及霍奇金淋巴瘤和非霍奇金淋巴瘤患者血清中这些细胞因子的水平。收集了60份来自霍奇金病（28例患者）或非霍奇金淋巴瘤（32例患者）患者的血清样本，以及20份来自正常志愿者的样本。大多数患者患有晚期（III或IV期）或复发性疾病。γ-干扰素的测定是一种特异性和灵敏度较高的放射免疫测定法（检测下限= 0.1单位/ml）;肿瘤坏死因子α、IL-1 β和IL-6的测定是酶联免疫测定法，灵敏度下限分别为10 pg/ml、20 pg/ml和22 pg/ml。淋巴瘤患者和正常受试者之间的γ-干扰素、肿瘤坏死因子α或IL-1 β水平没有统计学显著差异。淋巴瘤患者血清IL-6阳性率为35%（20/57），正常对照组为0%（0/19）（P < 0.005，χ 2检验）。有趣的是，29名具有B症状的淋巴瘤患者中有17名（59%）具有可检测的血清IL-6水平（P < 0.001，卡方检验），而28名没有B症状的淋巴瘤患者中有3名（11%）具有可检测的血清IL-6水平（P < 0.001，卡方检验）;中值IL-6水平为28.9 pg/ml（存在B症状）与不可检测的（没有B症状）（P < 0.005，Mann-Whitney U检验）。分别分析霍奇金淋巴瘤和非霍奇金淋巴瘤组显示了相似的结果。IL-6水平与诊断时间、β 2-微球蛋白或乳酸脱氢酶水平无显著相关性。然而，Kaplan和Meir方法的分析表明，可检测到IL-6水平（>或= 22 pg/ml）的霍奇金病患者的中位生存期为10个月，而具有较低值的患者在中位随访时间37.5个月时尚未达到中位生存期（Wilcoxon P值= 0.0012）。每个非霍奇金淋巴瘤亚组中的患者太少，无法确定IL-6与生存率之间的相关性，但作为一个单一组，未发现统计学显著相关性。（400字处截断摘要）
Several cytokines including gamma-interferon, tumor necrosis factor alpha, interleukin 1 beta (IL-1 beta), and interleukin 6 (IL-6) are pyrogenic and can inhibit lipogenic processes. Because patients with lymphoma often suffer from fever, weight loss, and night sweats (B symptoms), the etiology of which is unknown, the authors investigated serum levels of these cytokines in normal volunteers and in patients with Hodgkin's and non-Hodgkin's lymphoma. Sixty serum samples from patients with Hodgkin's disease (28 patients) or non-Hodgkin's lymphoma (32 patients), as well as 20 samples from normal volunteers, were collected. The majority of patients had advanced (Stage III or IV) or relapsed disease. The assay for gamma-interferon was a specific and sensitive radioimmunoassay (lower limit of detection = 0.1 unit/ml); the assays for tumor necrosis factor alpha, IL-1 beta, and IL-6 were enzyme-linked immunoassays with lower limits of sensitivity of 10 pg/ml, 20 pg/ml, and 22 pg/ml, respectively. There were no statistically significant differences in gamma-interferon, tumor necrosis factor alpha, or IL-1 beta levels between lymphoma patients and normal subjects. In contrast, 20 of 57 patients (35%) with lymphoma as compared with 0 of 19 normal volunteers (0%) had detectable serum IL-6 levels (P < 0.005, chi 2 test). Interestingly, 17 of 29 lymphoma patients with B symptoms (59%) as opposed to 3 of 28 lymphoma patients without B symptoms (11%) had detectable serum IL-6 levels (P < 0.001, chi 2 test); the median IL-6 level was 28.9 pg/ml (B symptoms present) versus undetectable (no B symptoms) (P < 0.005, Mann-Whitney U test). Analyzing Hodgkin's and non-Hodgkin's lymphoma groups separately revealed similar results. IL-6 levels showed no significant correlation with time from diagnosis, beta 2-microglobulin, or lactate dehydrogenase levels. However, analysis by the method of Kaplan and Meir demonstrated that the median survival of Hodgkin's disease patients with detectable IL-6 levels (> or = 22 pg/ml) was 10 mo, whereas the median survival has not been reached at a median follow-up time of 37.5 mo in those patients with lower values (Wilcoxon P value = 0.0012). There were too few patients in each subset of non-Hodgkin's lymphoma to determine the correlation between IL-6 and survival but, considered as a single group, a statistically significant correlation was not found.(ABSTRACT TRUNCATED AT 400 WORDS)
有证据表明肿瘤坏死因子在裸鼠人类肿瘤恶病质、高钙血症和白细胞增多等副肿瘤综合征中发挥致病作用。
DOI：
10.1172/jci115106
发表时间：
1991
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Yoneda,T;Alsina,MA;Chavez,JB;Bonewald,L;Nishimura,R;Mundy,GR
通讯作者：
Mundy,GR