恶性淋巴瘤血清中可溶性CD40配体与肿瘤坏死因子α表达的临床意义

目的研究恶性淋巴瘤（ML）患者血清中可溶性CD40配体（sCD40L）和肿瘤坏死因子α（TNF-α）的表达，分析血清中sCD40L和TNF-α的关系。方法应用酶联免疫吸附法检测39例ML（其中初治17例，复发病例22例）血清中sCD40L和TNF-α水平；同时检测正常人20例血清中sCD40L和TNF-α水平。结果ML患者血清sCD40L表达明显低于对照组（P〈0．01）；TNF-α明显高于对照组（P〈0．01）。高度恶性ML血清sCD40L水平（0．06±0．03）μg／L比中、低度恶性（0．38±0．13）μg／L，（0．82±0．26）μg／L明显降低（P〈0．01）。高度恶性ML血清TNF-α水平（50．74±6．63）ng／L比中、低度恶性（34．29±8．34）ng／L、（23．33±6．64）ng／L明显升高（P〈0．01）。化疗缓解组血清sCD40L水平（0．96±0．20）μg／L比无效组（0．28±0．236）μg／L明显升高，TNF-α水平缓解组（13．74±9．02）ng／L，无效组（37．23±10．73）ng／L明显降低（P〈0．01）。ML患者血清sCD40L水平和TNF-α水平呈负相关（r=-0．233，P〈0．05）。结论恶性淋巴瘤患者血清sCD40L表达降低，TNF-α表达升高；二者在血清中的表达有一定的相关性。sCD40L有可能作为预测恶性淋巴瘤预后的一个指标。

Expression of soluble CD40 ligand and tumor necrosis factor-α in malignant lymphoma patients

Objective To study the relatonship and the expression between serum soluble CD40 ligand （sCD40L） and tumor necrosis faetor-α （TNF-α） in malignant lymphoma （ML） patients. Methods The levels of sCD40L and TNF-α were tested by ELISA method in serum of 39 ML patients （including 17 newly diagnosed cases,22 relapsed cases）. At the same time, the levels of sCD40L and TNF-α were tested by ELISA method in serum of 20 normal healthy people. Results sCD40L in ML patients was lower than that of control group（ P 〈0.01） ,TNF-α was higher than that of control group （P 〈0.01）. The levels of serum sCD40L and TNF-α had significant difference between high grade （0.06±0.03） μg/L, （50.74± 6.63） ng/L and intermediate （0.38±0.13） 9g/L, （34.29±8.34） ng/L or low grade （0.82±0.26） μg/L, （23.33±6.64） ng/L ML patients（ P 〈0.01）. After chemotherapy treatment, the level of serum sCD40L （0.96±0.20） μg/L was higher and TNF-α （13.74± 9.02） ng/L was lower in patients reaching complete remission or partial remission（CR or PR） than invalid group （0.28±0. 236） μg/L, （37.23±10.73） ng/L（ P 〈 0.01）. The levels of serum sCD40L and TNF-α had negative correlation （r =-0. 233, P 〈 0.05）. Conclusion The lower level of sCD40L and the higher level of TNF-α are expressed in ML patients. The relatonship exists between sCD40L and TNF-α. sCD40L will become a prognosis target in malignant lymphoma.