多发性骨髓瘤患者血清中IL-6与IL-27水平监测的临床应用

目的 通过检测多发性骨髓瘤(multiple myeloma,MM)患者血清中IL-6与IL-27表达水平,探讨其在MM病情进展程度及疗效评价中的意义。方法 按照修订的R-ISS国际预后分期诊断标准,选择MM患者52例,其中Ⅰ期16例,Ⅱ期18例,Ⅲ期18例,选择同期正常对照组20例。用ELISA法检测各组血清中IL-6与IL-27表达水平,并随访观察其预后。结果 Ⅰ期、Ⅱ期与Ⅲ期MM患者血清中IL-6表达水平均明显高于对照组,且差异有统计学意义(t=4.012,5.134,6.161,均P<0.01),Ⅲ期血清中IL-6的表达水平高于Ⅰ期,且差异有统计学意义(t=2.132,P<0.05)。而Ⅲ期IL-27表达水平显著低于对照组,且差异有统计学意义(t=3.831,P<0.01),Ⅰ期、Ⅱ期血清中IL-27表达水平也低于对照组,且差异有统计学意义(t=2.012,2.198,均P<0.05)。MM患者血清中IL-6表达水平与IL-27表达水平为负相关关系(r=-0.510,P<0.05)。MM患者初治组与复发组血清中IL-6的表达水平均明显高于对照组,且差异有统计学意义(t=4.331,5.221,均P<0.01),而缓解组IL-6表达水平显著低于初治组,且差异有统计学意义(t=4.101,P<0.01)。初治组与复发组血清中IL-27的表达水平均明显低于对照组,且差异有统计学意义(t=2.133,2.521,均P<0.05),而缓解组IL-6表达水平高于初治组,且差异有统计学意义(t=2.001,P<0.05)。结论 多发性骨髓瘤的病情进展与患者血清中IL-6升高或IL-27降低有关,检测相关细胞因子IL-6和IL-27水平变化有助于判断病情严重程度及评估预后。

Clinical Application of Monitoring IL-6 and IL-27 Levelsin Patients with Multiple Myeloma

Objective Through the detection of IL-6 and IL-27 expression levels in sera of patients with multiple myeloma,to explore its significance of judging the extent of serious condition and treatment of multiple myeloma.Methods According to the revision of the R-ISS international prognostic staging diagnosis standards,selected 52 patients with multiple myeloma,Ⅰ period of 16 cases,Ⅱ period 18 cases,Ⅲ period 18 cases,and 20 cases at same time as for as normal control group.Detected serum IL-6 and IL-27 expression levels in each group with ELISA method,and the prognosis wasfollowed up and observed.Results Serum IL-6 expression levels in Ⅰ,Ⅱ and Ⅲ stage of patients with MM were significantly higher than that of control group,and the difference was statistically significant(t=4.012,5.134,6.161,P<0.01).In Ⅲ period,the expression levelof IL-6 in serum was higher than Ⅰ period,and the difference was statistically significant(t=2.132,P<0.05).And in Ⅲ period,IL-27 expression level was significantly lower than the control group,and the difference was statistically significant(t=3.831,P<0.01).In Ⅰ,Ⅱ stage,serum IL-27expression level was lower than the control group,and the difference was statistically significant(t=2.012,2.198,P<0.05).Serum IL-6 and IL-27expression levels in patients with MM were negative correlation(r=0.510,P<0.05).Serum IL-6 expression levels in first-treated group and recurrence group of patients with MM were significantly higher than that of control group,and the difference was statistically significant(t=4.331,5.221,P<0.01).While IL-6 expression level of alleviated group was significantly lowerthan in the early treated group,and the difference was statistically significant(t=4.101,P<0.01).Serum IL-27 expression levels of initial groupand recurrence group were significantly lower than the control group,and the difference was statistically significant(t=2.133,2.521,P=<0.05).Serum IL-6 expression level of alleviated group was higher than the initial group,and the difference was statistically significant(t=2.001,P<0.05).Conclusion The progression of multiple myeloma was relatedto the increasion of IL-6 or the decreasion of IL-27.Testing related cytokines IL-6 and IL-27 level changes help to determine disease severity and assessing prognosis.