IL-6在Castleman病中的表达及其临床病理学意义分析

Abstract

目的 研究Castleman病(Castleman's disease,CD)患者IL-6的表达情况,并分析其临床病理学意义.方法 收集92例CD患者标本,免疫组化法检测其IL-6的表达情况,并以20例淋巴结反应性增生(Lymph node reactive hyperplasia,LRH)患者标本作为对照组.结果 92例CD患者中男56例,女36例,中位年龄41(4 ～90)岁.其中多中心型(MCD)42例,单中心型(UCD) 50例；浆细胞型(PC-CD) 62例,透明血管型(HV-CD) 30例.所有患者HIV检测均阴性.92例CD患者中77例(83.7％) IL-6表达阳性,20例LRH患者仅1例(5.0％)表达阳性.各型CD患者中IL-6阳性表达率分别为:MCD 90.5％,UCD 78.0％;PC-CD 93.6％,HV-CD 63.4％,不同病理分型的阳性表达率差异有统计学意义(P =0.001).PC-CD组患者浆细胞高表达IL-6 (75.8％),MCD组患者浆细胞IL-6阳性率明显高于UCD组(P =0.003)；PC-CD组患者血管内皮细胞IL-6阳性率明显高于HV-CD组(P=0.008)；巨噬细胞和生发中心滤泡树突细胞的IL-6阳性率较低,分别为10.9％和3.3％.77例IL-6阳性患者中41例(53.2％)出现系统症状,而15例阴性患者中仅3例(20.0％)出现,差异有统计学意义(P =0.018).浆细胞和巨噬细胞表达IL-6阳性者出现系统症状的概率较阴性者显著增高(P值分别为0.007和0.039),浆细胞表达IL-6阳性者出现B症状的概率较阴性者明显增高(P=0.041).结论 IL-6在CD中有很高的表达率,与LRH不同.IL-6的表达与CD分型及系统症状密切相关.IL-6的检测对CD的诊断和治疗有重要的指导意义.

To evaluate the expression of interleukin-6 (IL-6) and its clinicopathological significance in Castleman's disease (CD).Clinical data and paraffin blocks of 92 CD patients and 20 cases of lymph node reactive hyperplasia (LRH) as a control group were collected from department of pathology of Peking University Health Science Center. The expression of IL-6 was detected by using immunohistochemical method.The 92 patients were composed of 42 multicentric variant (MCDs) and 50 unicentric variant (UCDs) clinically, and 30 hyaline-vascular variant (HV-CDs) and 62 plasma cell variant (PC-CDs) morphologically. None of them was positive for HIV tests. There were 56 males and 36 females, and their ages ranged from 4 years to 90 years with the median 41 years. IL-6 was expressed in 77 (83.7%) of 92 CD cases and 1 (5.0%) of 20 LRH cases. The expression rate of IL-6 was 90.5% in MCDs, 78.0% in UCDs, 93.6% in PC-CDs and 63.4% in HV-CDs, respectively. PC-CD cases showed a significantly higher expression rate of IL-6 than HV-CD cases (P = 0.001). All cases with positive IL-6 expression in plasmacytes were PC-CDs, showing obviously higher expression in MCDs than that in UCDs (P = 0.003). Compared with HV-CD cases, much more PC-CD cases showed IL-6 positivity in endothelial cells (P = 0.008). However, IL-6 was rarely expressed by both FDCs and macrophages, with only 3.3% and 10.9% positive cases, respectively. There are 53.2% (41/77) of the IL-6 positive cases and 20.0% (3/15) of IL-6 negative cases suffered from systemic symptoms, showing a significant difference between the two groups (P = 0.018). Cases with IL-6 expression in plasmacytes and macrophages were more likely to suffer from systemic symptoms, especially B type symptoms (P < 0.05).There is a high expression rate of IL-6 in CD, which is different from LRH. The expression of IL-6 has close relationship with CD subtypes and the presence of systemic symptoms. In all, the evaluation of interleukin-6 is of great value to guide the diagnosis and therapy of CD.