作者简介:陈 朴,1978年生,男,副主任技师,硕士,主要从事淋巴造血系统肿瘤的实验室综合诊断工作。 通信作者:王蓓丽,E-mail:wang.beili1@zs-hospital.sh.cn。炎症相关细胞因子与 Ph 阴性骨髓增殖性肿瘤的相关性陈　朴 1 , 马艳婷 1 , 陈　楠 1 , 于正麟 1 , 程韵枫 2 , 潘柏申 1 , 郭　玮 1 , 王蓓丽 1(1.复旦大学附属中山医院检验科,上海 200032;2. 复旦大学附属中山医院血液科,上海 200032)摘要:目的　探讨经典型骨髓增殖性肿瘤(MPN)患者血清炎症相关细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、白细胞介素2受体(IL-2R)、IL-6、IL-8、IL-10]水平及其临床意义。方法　选取50例费城染色体(Ph)阴性(Ph - )的初诊MPN患者[MPN组,其中真性红细胞增多症(PV)16例、原发性血小板增多症(ET)25例、原发性骨髓纤维化(PMF)9例],以20名体检健康者作为正常对照组,采用化学发光法检测血清TNF-α、IL-1β、IL-2R、IL-6、IL-8及IL-10水平,采用Sanger测序法检测MPN患者JAK2及MPL基因突变,采用实时荧光聚合酶链反应(PCR)检测CALR基因突变。结果　MPN组血清TNF-α、IL-2R、IL-6和IL-8水平均显著高于正常对照组(P<0.001),血清IL-10水平显著低于正常对照组(P<0.001)。2个组之间血清IL-1β水平差异无统计学意义(P>0.05)。PMF组血清IL-2R水平高于PV组和ET组(P<0.05)。在JAK2 V617F突变阳性患者中,PMF组血清IL-2R水平显著高于PV组和ET组(P<0.01),血清TNF-α和IL-8水平高于ET组(P<0.05),血清IL-6水平高于PV组(P<0.05)。骨髓纤维化分级为MF-3级的MPN患者IL-2R水平高于MF-2级患者(P<0.05),TNF-α水平高于MF-0级患者(P<0.05)。结论　MPN患者炎症相关细胞因子(TNF-α、IL-1β、IL-2R、IL-6、IL-8及IL-10)水平异常,且在3种MPN亚型之间也存在差异,或许可作为MPN诊断分型及随访的辅助参考指标。关键词:肿瘤坏死因子-α;白细胞介素1β;白细胞介素2受体;白细胞介素6;白细胞介素8;白细胞介素10;骨髓增殖性肿瘤Inflammatory cytokine levels in patients with philadelphia chromosome-negative myeloproliferative neoplasms CHEN Pu 1 ,MA Yangting 1 ,CHEN Nan 1 ,YU Zhenglin 1 ,CHENG Yunfeng 2 ,PAN Boshen 1 ,GUO Wei 1 ,WANG Beili 1 .(1.Department of Laboratory Medicine,Zhongshan Hospital,Fudan University,Shanghai 200032,China;2. Department of Hematology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)Abstract:Objective　To investigate serum levels of inflammatory cytokines in patients with classical myeloproliferative neoplasms(MPN) [tumor necrosis factor-alpha(TNF-α),interleukin-1 beta(IL-1β),interleukin-2 receptor(IL-2R),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10)] and their clinical signif i cance. Methods　The serum levels of TNF-α,IL-1β,IL-2R,IL-6,IL-8 and IL-10 were detected by chemiluminescence immunoassay(CLIA)in 50 patients with Philadelphia chromosome-negative(Ph - ) newly diagnosed MPN [MPN group,including 16 cases of polycythemia vera(PV),25 cases of essential thrombocytosis(ET) and 9 cases of primary myelofibrosis(PMF)] and 20 healthy volunteers(control group). Sanger sequencing was used to detect JAK2 and MPL mutations,and CALR mutation was detected by real-time fl uorescent polymerase chain reaction(PCR) in MPN patients. Results　The serum levels of TNF-α,IL-2R,IL-6 and IL-8 in MPN group were signif i cantly higher than those in control group(P<0.001),while IL-10 level was on the contrary(P<0.001). There was no signif i cant difference in serum IL-1β level between the two groups(P>0.05). IL-2R 文章编号 :1673-8640(2021)02-0167-06 中图分类号 :R446.1 文献标志码 :A DOI :10.3969/j.issn.1673-8640.2021.02.009 ·168