淋巴瘤组织和血浆中TNT-α表达及其临床意义

摘要

Purpose To investigate expression of tumor necrosis factor α ( TNF-α ) in lymphoma tissue and plasma, as well as the relationship hetween clinical outcome and prognosis of lymphoma. Methods 97 cases of lymphoma paraffin tissue and plasma samples were collected, and the expression of TNF-α in tissue and plasma were used by immunohistochemical methods and ELISA . Results Variable expression of TNF-α was observed in various subtypes of lymphoma which there were significant difference between plasma cell neoplasm( PCL ) and lymphoblastic lymphoma( LBL ), LBL and peripheral T-cell lymphoma( PTL ) ( P ＜ 0. 05 ). All plasma levels of TNF-α group in lymphoma patients were higher than control group, except for LBL and PCN, which Hodgkin ' s lymphoma ( HL )、small lymphocytic lymphoma( SLL )、follicular lymphoma ( FL )、NK/T cell lymphoma( NK / TCL ), mantle cell lymphoma( MCL ) were higher than that in control group ( P ＜ 0. 05 ). The expression of TNF-α in male patients、Ann Ardor stage Ⅳ , IPI index of high-risk group and the group of B symptoms were significantly higher than the expression of women、 Ann Ardor stage Ⅰ -Ⅲ ,IPI low-intermediate risk index and no B symptoms group( P ＜ 0. 05 ). There were no difference at different ages, ethnic, LDH, CRP, β2-MG ( P ＞ 0. 05 ).There were not difference between the expression of TNF-α in tissue and clinical parameters of the different groups( P ＞ 0. 05 ). The expression of TNF-α in plasma was negatively correlated to that of tissues ( r = 0. 119, P ＞ 0. 05 ). Conclusion The high expression of TNF-α in the patients with lymphoma may be correlated to the development of lymphoma . Plasma levels of TNF-α may more meaningful to evaluate clinical prognosis.%目的 探讨不同类型淋巴瘤患者组织和血浆肿瘤坏死因子α(TNF-α)表达状况,以及与临床预后参数的关系.方法 收集97例淋巴瘤患者石蜡组织和血浆标本,用Super Vision两步法免疫组化和ELISA法分别检测TNF-α在组织和血浆中的表达.结果 TNF-α在不同类型的淋巴瘤组织中均有不同程度的表达,组间比较浆细胞肿瘤(plasma cell neoplasm,PCN)与淋巴母细胞性淋巴瘤(lymphoblastic lymphoma,LBL)、LBL与外周T细胞淋巴瘤(peripheral T-cell lymphoma,PTL)组间差异有显著性(P<0.05).血浆TNF-α水平除PCN和LBL外,淋巴瘤患者组皆高于对照组,其中霍奇金淋巴瘤(Hodgkin's lymphoma,HL)、小淋巴细胞淋巴瘤(small lymphocytic lymphoma,SLL/CLL)、滤泡性淋巴瘤(follicular lymphoma,FL)、NK/T细胞淋巴瘤(NK/T cell lymphoma,NK/TCL)和套细胞淋巴瘤(mantle cell lymphoma,MCL)与对照组间的差异有显著性(P<0.05).血浆中TNF-α表达在淋巴瘤患者男性组、Ann Ardor分期Ⅳ、国际预后指数(international prognostic index,IPI)高危组、有B症状组间表达明显高于女性组、Ann Ardor分期Ⅰ～Ⅲ、IPI低、中危、无B症状组,组间差异有显著性(P<0.05).在不同年龄、民族、乳酸脱氢酶(lactic dehydrogenase,LDH)、C反应蛋白(C-reactive protein,CRP)、β2-微球蛋白(β2-microglobulin,β2-MG)间的差异无显著性(P>0.05);而组织中TNF-α表达与以上临床参数不同组间差异皆无显著性(P>0.05).淋巴瘤患者TNF-α血浆和组织中的表达无相关关系(r=0.119,P>0.05).结论 TNF-α在多种类型淋巴瘤患者中组织和血浆中高表达,说明TNF-α可能在淋巴瘤的发生、发展中起着作用.血浆中TNF-α水平的检测对淋巴瘤临床预后判断有一些参考价值.