恶性肿瘤合并慢性贫血、缺铁性贫血及合并贫血患者细胞因子分泌的比较及其对红细胞生成的影响

Q4 Medicine
V. Sakhin, E. Kryukov, S. P. Kazakov, A. Sotnikov, A. Gordienko, M. A. Zavartsev, O. Rukavitsyn
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In accordance with Van Santen and Worwood criteria, by determining the transferrin saturation coefficient, ferritin concentrations, C-reactive protein, patients were divided into 4 groups: group 1 – patients with ACD, 31 (20 / 11 patients), 2 group – ACD / IDA, 28 (18 / 10 patients), group 3 – IDA, 25 (17 / 8 patients), group 4 (control) – 22 patients without anemia. In all patients, the number of erythrocytes, the concentration of hemoglobin, ferritin, C-reactive protein, transferrin saturation coefficient, IL-6, TNF-α, IL-10 were determined. For quantitative indicators, the arithmetic mean and interquartile range (IQR) were calculated. Significance of differences between several unrelated groups was determined using the Kruskal–Wallis test. To assess the relationship between variables, the Spearman correlation coefficient (r) was calculated.Results. 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引用次数: 0

摘要

的目标。比较慢性贫血(ACD)、缺铁性贫血(IDA)及两种贫血合并的癌症患者白细胞介素-6 (IL-6)、白细胞介素-10 (IL-10)和肿瘤坏死因子-α (TNF-α)的分泌情况。针对不同类型的贫血,分别评价所研究的细胞因子对恶性肿瘤患者红细胞生成的影响。材料和方法。106例II-IV期实体恶性肿瘤患者:贫血84例(男55例,女29例,67.1±9.9岁),无贫血22例(男17例,女5例,平均年龄60.2±14.9岁)。根据Van Santen和Worwood标准,通过测定转铁蛋白饱和系数、铁蛋白浓度、c反应蛋白,将患者分为4组:1组- ACD患者,31例(20 / 11例),2组- ACD / IDA, 28例(18 / 10例),3组- IDA, 25例(17 / 8例),4组(对照)- 22例无贫血。测定所有患者红细胞数量、血红蛋白、铁蛋白、c反应蛋白浓度、转铁蛋白饱和系数、IL-6、TNF-α、IL-10。定量指标计算算术平均值和四分位差(IQR)。使用Kruskal-Wallis检验确定几个不相关组之间差异的显著性。为了评估变量之间的关系,计算Spearman相关系数(r)。ACD组与ACH3 / IDA组(IL-6 - 9.3 [IQR 4.4-13.2]、TNF-α - 7.2 [IQR 4.5-9.6]、IL-10 - 6.7 [IQR 4.1-11.4])和IDA组(IL-6 - 3.4 [IQR 1.4-5.9]、TNF-α - 4.6 [IQR 3.7-6]、IL-10 - 2.5 [IQR 0-5])比较,IL-6浓度最高为73.3 (IQR 6.2-51)、TNF-α - 24.4 (IQR 15.3-60.7)、IL-10 - 8.7 (IQR 4.7-12.1),差异均有统计学意义(p <0.05)。在ACD组,IL-6与红细胞(r = -0.74)和血红蛋白(r = -0.88)、TNF-α与红细胞(r = -0.66)和血红蛋白(r = -0.77)、IL-10与红细胞(r = -0.36)和血红蛋白(r = -0.63)的相关系数最高。在IDA组中,细胞因子、红细胞和血红蛋白的相关系数较低或不存在。在癌症患者中,ACD, IDA,以及它们的组合都可能发生。细胞因子分泌增加在ACD组患者中是重要的,因为细胞因子对红细胞生成有很强的负作用。为了改善治疗,需要进一步研究ACD的发病机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of cytokine secretion and study of their effect on erythropoiesis in patients with malignant neoplasms with anemia of chronic disease, iron deficiency anemia, and their combination
Aim. To compare the secretion of interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-α) in cancer patients with anemia of chronic disease (ACD), iron deficiency anemia (IDA) and a combination of these two anemia types. To assess the effect of the studied cytokines on erythropoiesis in patients with malignant neoplasms separately for each type of anemia studied.Materials and methods. 106 patients with stage II–IV of solid malignant neoplasms were examined: 84 with anemia (55 men, 29 women, 67.1 ± 9.9 years), 22 without anemia (17 men, 5 women, mean age 60.2 ± 14.9 years). In accordance with Van Santen and Worwood criteria, by determining the transferrin saturation coefficient, ferritin concentrations, C-reactive protein, patients were divided into 4 groups: group 1 – patients with ACD, 31 (20 / 11 patients), 2 group – ACD / IDA, 28 (18 / 10 patients), group 3 – IDA, 25 (17 / 8 patients), group 4 (control) – 22 patients without anemia. In all patients, the number of erythrocytes, the concentration of hemoglobin, ferritin, C-reactive protein, transferrin saturation coefficient, IL-6, TNF-α, IL-10 were determined. For quantitative indicators, the arithmetic mean and interquartile range (IQR) were calculated. Significance of differences between several unrelated groups was determined using the Kruskal–Wallis test. To assess the relationship between variables, the Spearman correlation coefficient (r) was calculated.Results. In the ACD group, the maximum IL-6 concentration was 73.3 (IQR 6.2–51), TNF-α – 24.4 (IQR 15.3–60.7) and IL-10 – 8.7 (IQR 4.7–12.1) compared with the ACH3 / IDA group (IL-6 – 9.3 [IQR 4.4–13.2], TNF-α – 7.2 [IQR 4.5–9.6] and IL-10 – 6.7 [IQR 4.1–11.4]), and the IDA group (IL-6 – 3.4 [IQR 1.4–5.9], TNF-α – 4.6 [IQR 3.7–6] and IL-10 – 2.5 [IQR 0–5]) (p <0.05). In the ACD group, the highest correlation coefficients were found between IL-6 and erythrocytes (r = –0.74) and hemoglobin (r = –0.88), between TNF-α and erythrocytes (r = –0.66) and hemoglobin (r = –0.77), between IL-10 and erythrocytes (r = –0.36) and hemoglobin (r = –0.63). In the IDA group, the correlation coefficients between cytokines, erythrocytes, and hemoglobin are low or absent.Conclusion. In cancer patients, ACD, IDA, as well as their combination can occur. Increased cytokine secretion in ACD group patients is important due to the proven strong negative effect of cytokines on erythropoiesis. Further study of ACD pathogenesis is needed in order to improve treatment.
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