Abstract:

Objective　To explore the serum level of interleukin-6 (IL-6) in patients with newly diagnosed diffuse large B-cell lymphoma (ND-DLBCL) and its clinical significance. Methods　A total of 66 patients with ND-DLBCL who were admitted to Fuzhou Second General Hospital and Fujian Medical University Union Hospital and 35 cases of healthy control individuals from Oct 2017 to Dec 2021 were selected for the retrospective analysis. Among the patients with ND-DLBCL, there were 39 males and 27 females with a median age of 59 years old. Among the healthy control individuals, there were 10 males and 25 females with a median age of 39 years old. The serum IL-6 levels were compared between the two groups. Of the 66 ND-DLBCL patients, 4 were lost to follow-up and 62 were included for further analysis. The optimal cut-off value of serum IL-6 level to predict prognosis was obtained by the receiver operating characteristic curve. The patients were divided into a high level group (IL-6 ≥15.6 ng/L, 39 cases) and a low level group (IL-6 <15.6 ng/L, 23 cases) according to the cut-off value. The clinical and laboratory characteristics, 3-year overall survival (OS) and progression-free survival (PFS) of the two groups were compared. χ² test and t test were used for statistical analysis. Results　The serum level of IL-6 in the patients with ND-DLBCL [(35.95±33.66) ng/L] was higher than that in the healthy control individuals [(1.66±0.77) ng/L] (t=6.012, P<0.001). The optimal cut-off value of serum level of IL-6 for prognosis in patients with ND-DLBCL was 15.6 ng/L, and the area under curve was 0.705 (0.558-0.852) (P<0.05). Compared with the group with low level of serum IL-6, the proportions of the patients with presence of B symptoms [58.97% (23/39) vs. 13.04% (3/23)] and high National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) (≥4 points) [79.49% (31/39) vs. 43.48% (10/23)] were higher in the high level group, but the OS rate of 3-year [71.79% (28/39) vs. 100.00% (23/23)] and the PFS rate of 3-year [56.41% (22/39) vs. 82.61% (19/23)] were lower in the high level group (all P<0.05). Conclusions　There was an abnormal elevation of serum IL-6 level in patients with ND-DLBCL. Meanwhile, high level of serum IL-6 was associated with poor prognosis in patients with ND-DLBCL.

Key words:

Diffuse large B cell lymphoma, Interleukin-6, Prognosis

摘要：

目的　探讨初治弥漫大B细胞淋巴瘤（DLBCL）患者血清白细胞介素-6（IL-6）水平及其预后意义。方法　回顾性选取2017年10月至2021年12月初诊于福州市第二总医院和福建医科大学附属协和医院的初治DLBCL患者66例为病例组，选取福建医科大学附属协和医院同期健康体检志愿者35例为对照组。病例组男39例，女27例，中位年龄59岁；对照组男10例，女25例，中位年龄39岁。比较两组血清IL-6水平。66例初治DLBCL患者中4例失访，62例纳入进一步分析。采用受试者操作特征曲线获取血清IL-6水平预测患者预后的截断值，按截断值将患者分为高水平组（IL-6≥15.6 ng/L）39例和低水平组（IL-6<15.6 ng/L）23例。比较两组患者的临床和实验室特征及3年总生存期（OS）、无进展生存期（PFS）。采用χ²检验、t检验进行统计分析。结果　病例组患者的血清IL-6水平高于对照组［（35.95±33.66）ng/L比（1.66±0.77）ng/L］，差异有统计学意义（t=6.012，P<0.001）。血清IL-6水平预测DLBCL患者预后的最佳截断值为15.6 ng/L，曲线下面积为0.705，95%置信区间为0.558～0.852（P<0.05）。高水平组有B症状、美国国家综合癌症网络国际预后指数≥4分患者比例均高于低水平组［58.97%（23/39）比13.04%（3/23）、79.49%（31/39）比43.48%（10/23）］，3年OS率、PFS率均低于低水平组［71.79%（28/39）比100.00%（23/23）、56.41%（22/39）比82.61%（19/23）］，差异均有统计学意义（均P<0.05）。结论　初治DLBCL患者的血清IL-6水平异常升高，且血清IL-6高水平与患者不良预后有关。

关键词:

弥漫大B细胞淋巴瘤, 白细胞介素-6, 预后