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目的:检测人白介素11(interleukin-11,IL-11)基因在弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者组织和血清标本中的表达,探讨IL-11表达与DLBCL患者预后的关系及其对化疗后患者血小板减少的影响。方法:收集2012年1月至2016年12月于河北省邯郸市第一医院血液科确诊的88例DLBCL患者和42例反应性淋巴增生(reactive lymphoid hyperplasia,RLH)患者组织和血液标本。用q PCR方法检测肿瘤组织和血液中IL-11的表达,应用单因素和多因素Cox回归分析IL-11表达与DLBCL患者临床病理特征和预后的关系以及影响患者预后的独立因素,相关性分析DLBCL患者IL-11表达和化疗后血小板减少的关系,Kaplan-Meier法分析IL-11表达与DLBCL患者总生存(OS)时间、无进展生存(PFS)时间的关系。结果:与对照组RLH患者比较,IL-11在DLBCL患者组织和血液中表达显著升高(组织:7.002±0.357 vs 1.507±0.139;血液:6.700±0.337 vs1.446±0.126,均P<0.01)。IL-11表达与DLBCL患者的肿瘤大小、临床分期、B细胞症状、化疗敏感性及IPI指数相关(均P<0.01),IL-11高表达患者OS和PFS较IL-11低表达患者明显缩短(均P<0.01)。单因素及多因素Cox回归分析显示,IL-11表达、化疗敏感性和IPI指数是影响DLBCL患者预后的独立因素。化疗后血小板减少患者血清IL-11基因表达与血小板计数呈负相关(r=-0.732,P<0.01)。结论:IL-11在DLBCL患者组织和血液中高表达,IL-11高表达DLBCL患者OS和PFS明显缩短,化疗后血小板减少严重。IL-11有望成为DLBCL患者独立的预后评判生物学标志物。
OBJECTIVE: To detect the expression of interleukin-11 (IL-11) gene in the tissue and serum of patients with diffuse large B-cell lymphoma (DLBCL) and to investigate the relationship between IL-11 expression and DLBCL Relationship between prognosis and thrombocytopenia in patients after chemotherapy. Methods: Tissue and blood samples from 88 patients with DLBCL and 42 patients with reactive lymphoid hyperplasia (RLH) who were diagnosed as hematology in the First Hospital of Handan City, Hebei Province from January 2012 to December 2016 were collected. The q-PCR method was used to detect the expression of IL-11 in tumor tissues and blood. The relationship between IL-11 expression and the clinicopathological features and prognosis of DLBCL patients and the independent factors influencing the prognosis were analyzed by univariate and multivariate Cox regression analysis. Correlation analysis The relationship between IL-11 expression and thrombocytopenia after chemotherapy in DLBCL patients was analyzed by Kaplan-Meier method. The relationship between IL-11 expression and the total survival time (OS) and progression-free survival (PFS) was analyzed. Results: The expression of IL-11 in the tissue and blood of patients with DLBCL was significantly higher than that of the control group (tissue: 7.002 ± 0.357 vs 1.507 ± 0.139; blood: 6.700 ± 0.337 vs 1.446 ± 0.126, both P <0.01) . IL-11 expression was significantly correlated with tumor size, clinical stage, B cell symptom, chemosensitivity and IPI index (all P <0.01) in patients with DLBCL. The patients with high IL-11 expression had significantly shorter OS and PFS than those with low IL-11 expression (All P <0.01). Univariate and multivariate Cox regression analysis showed that IL-11 expression, chemosensitivity and IPI index were independent prognostic factors in patients with DLBCL. The level of IL-11 in patients with thrombocytopenia after chemotherapy was negatively correlated with platelet count (r = -0.732, P <0.01). Conclusion: IL-11 is highly expressed in the tissues and blood of patients with DLBCL. The OS and PFS of IL-11-overexpressing DLBCL patients were significantly shortened and the thrombocytopenia was serious after chemotherapy. IL-11 is expected to become an independent prognostic biomarker of DLBCL patients.