经典型MPN患者血清IL-6和铁蛋白的表达水平及其意义-东南大学学报医学版

经典型MPN患者血清IL-6和铁蛋白的表达水平及其意义

单位：1. 蚌埠医科大学附属蚌埠第三人民医院血液内科, 安徽蚌埠 233000;
2. 徐州医科大学附属医院血液内科, 江苏徐州 221000;
3. 蚌埠医科大学附属蚌埠第三人民医院检验科, 安徽蚌埠 233000

分类号：R551.3;R733.3

出版年·卷·期（页码）：2025·44·第一期（23-29）

摘要：

目的:通过检测经典型骨髓增殖性肿瘤(MPN)患者初诊时血清白细胞介素-6(IL-6)和铁蛋白(SF)的表达水平,探讨其在MPN分型、疗效评估中的意义。方法:收集2022年1月至2024年2月在蚌埠市第三人民医院初诊的80例经典型MPN患者(ET、PV、PMF等3种亚型)作为研究组,同期20例健康体检者作为对照组。分析MPN患者与健康体检者血清IL-6和SF的表达水平;采用ROC曲线预测其在MPN患者分型中的诊断价值;分析血清IL-6和SF在MPN患者合并脾大组与脾正常组间的表达情况,以及在PMF患者治疗有效组与无效组间表达情况。结果:研究组血清IL-6和SF水平明显高于对照组(P<0.05),尤其是在PMF组中血清IL-6和SF水平不仅明显高于对照组(P<0.000 1),且明显高于ET组和PV组(P<0.01)。ROC曲线分析显示,联合检测血清IL-6和SF预测诊断PMF与非PMF(ET与PV)时AUC为0.967,敏感度为90.00%,特异度为92.00%,优于两者单独预测(均P<0.001)。MPN患者合并脾大组血清IL-6和SF水平明显高于脾正常组(均P<0.05)。PMF治疗无效组血清IL-6和SF水平明显高于治疗有效组(均P<0.05)。结论:血清IL-6和SF可能参与了MPN疾病的发生、发展,尤其在PMF和MPN合并脾大患者中;初诊时联合检测血清IL-6和SF可预测MPN的分型,其水平升高预示着PMF患者疗效较差、预后不佳。

Objective: By testing the expression levels of serum interleukin-6(IL-6) and serum ferritin(SF) in patients with typical myeloid proliferative tumor(MPN) at the time of initial diagnosis, to explore their significance in MPN classification and efficacy evaluation. Methods: Collected 80 patients with classic MPN(including 3 subtypes ET,PV,PMF) who were initially diagnosed in the third People's Hospital of Bengbu from January 2022 to February 2024 as observation group, and 20 cases of healthy people with physical examination during the same period were selected as control group. The expression of serum IL-6 and SF was analyzed in the observation group with the control group. The ROC curve was applied to analyze the predictive value of MPN classification. The expressions of IL-6 and SF were analyzed between the MPN patients with splenomegaly and the normal spleen group and between the effective and ineffective treatment group of PMF patients. Results: Serum IL-6 and SF in observation group were significantly higher than those in the control group(P<0.05). Especially in the PMF group, serum IL-6 and SF levels were not only significantly higher than those in the control group(P<0.000 1), but also significantly higher than those in the ET group and PV group(P<0.01). ROC curve results showed the AUC of combined detection of serum IL-6 and SF to predict PMF and non-PMF was 0.967, with a sensitivity of 90.00% and a specificity of 92.00%, which was better than IL-6 and SF alone. The expressions of IL-6 and SF in the MPN patients with splenomegaly were significantly higher than those with normal spleen(P<0.05). In patients with PMF, the expressions of serum IL-6 and SF in the treatment-ineffective group were significantly higher than those in the treatment-effective group(P<0.05). Conclusion: Serum IL-6 and SF may be involved in the occurrence and development of MPN diseases, especially in patients with PMF or MPN combined with splenomegaly. Combined detection of serum IL-6 and SF at the initial diagnosis can predict the type of MPN, and the elevated of serum IL-6 and SF indicates poor efficacy and worse prognosis in patients of PMF.

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