Objective: To investigate the expression and clinical significance of soluble B7-H3 (sB7-H3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).
Methods: The plasma samples of 85 newly diagnosed sHLH patients from December 2012 to April 2018 were collected. The patients were divided into lymphoma-related HLH（LHLH）group and infection-related HLH（IHLH）group. The expression of sB7-H3 in plasma was detected by ELISA, and the clinical data were collected for analysis. Fifteen healthy people were chosen as control group.
Results: The expression level of sB7-H3 in lymphoma-related HLH and infection-related HLH group significant increased as compared with the control group, (P＜0.05), and the expression level of sB7-H3 in lymphoma-related HLH group was significant higher than that in infection-related HLH group [(35.75± 9.90) vs (28.70±8.95) ng/ml)] (P＜0.001). There were no significant statistical difference in the expression of some clinical factors (including age, fever, splenomegaly, ANC, Plt, FIB, calcium ion, serum albumin, LDH, serum ferritin, sCD25) in lymphoma-related HLH and infection-related HLH group (P＞0.05). The evaluation of expression and significance of sB7-H3 in sHLH by using ROC curve, showed that the area under ROC curve comparison of patients in lymphoma-related HLH group and infection-related HLH group was 0.718 (95% CI 0.610-0.810) (P=0.0002), and predicting the sensitivity and specificity of the lymphoma-related HLH patients were 77.36% and 59.38%, respectively. The best cut-off value of patients in sB7-H3 was 29.81 ng/ml, the overall survival time of sB7-H3 high-expression group (≥29.81 ng/ml) was significant shorter than that in low-expression group (＜29.81 ng/ml) (24 vs 440 d) (P＜0.001). The clinical factors affecting the survival status of sHLH patients were neutrophils, albumin, serum ferritin, serum calcium ions and sB7-H3 levels.
Conclusion: sB7-H3 associates with poor prognosis of sHLH patients, and may be involved in disease progression.
题目: 可溶性B7-H3在继发性噬血细胞性淋巴组织细胞增多症患者中的表达及临床意义.
目的: 探讨可溶性B7-H3（sB7-H3）在继发性噬血细胞性淋巴组织细胞增多症（sHLH）患者中的诊断及预后意义.
方法: 收集2012年12月至2018年4月收治的85例初诊sHLH患者初次就诊时的血浆标本，并按照病因将患者分为淋巴瘤相关HLH（LHLH）组和感染相关HLH（IHLH）组。应用ELISA实验检测患者血浆中sB7-H3的表达，同时收集患者的临床资料进行分析并以15例健康体检者为对照组.
结果: 与对照组相比较，淋巴瘤相关HLH组和感染相关HLH组sB7-H3的表达均明显升高（P＜0.05），淋巴瘤相关HLH组sB7-H3的表达明显高于感染相关HLH组（(35.75±9.90) vs (28.70±8.95) ng/ml）（P＜0.001）。淋巴瘤相关HLH组与感染相关HLH组患者部分临床指标(包括年龄、发热、脾肿大、ANC、Plt、FIB、钙离子、血清白蛋白、LDH、血清铁蛋白、sCD25)的表达均无明显统计学差异（P＞0.05）。应用ROC曲线评价sB7-H3在sHLH的表达及意义结果显示，在与感染相关HLH患者的对比中，ROC（AUC）曲线下面积为0.718（95% CI 0.610-0.810）（P=0.0002)，预测淋巴瘤相关HLH患者的敏感性和特异性分别为77.36%和59.38%。ROC曲线分析sB7-H3的最佳cut-off值为29.81 ng/ml，sB7-H3高表达组（≥29.81 ng/ml）总生存中位时间较低表达组（＜29.81 ng/ml）明显缩短（24 vs 440 d）（P＜0.001）。影响sHLH患者生存状态的临床指标分别是中性粒细胞、白蛋白、血清铁蛋白、血清钙离子和sB7-H3水平.
结论: sB7-H3与sHLH影响不良预后的相关因素并可能参与疾病进展.