DataSheet_1_Increased Cytokine Levels Assist in the Diagnosis of Respiratory Bacterial Infections or Concurrent Bacteremia in Patients With Non-Hodgkin’s Lymphoma.docx

Non-Hodgkin’s lymphoma (NHL) is a form of tumor that originates in the lymphoid tissues. Bacterial infections are very common in NHL patients. Because most of the patients do not experience apparent symptoms during the initial stage of infection, it is difficult to detect the underlying condition before it progresses to a more critical level. The activation of the cytokines is a hallmark of inflammation. Due to the advantages of short detection time and high sensitivity of cytokines, many studies have focused on relationship between cytokines and infection. However, few studies have been conducted on NHL patients with infection. Therefore, we reviewed the cytokine profiles of 229 newly diagnosed NHL patients and 40 healthy adults to predict respiratory bacterial infection and bacteremia. Our findings revealed that IL-6(41.67 vs 9.50 pg/mL), IL-8(15.55 vs 6.61 pg/mL), IL-10(8.02 vs 4.52 pg/mL),TNF-β(3.82 vs 2.96 pg/mL), IFN- γ(4.76 vs 2.96 pg/mL), body temperature(37.6 vs 36.5°C), CRP(20.80 vs 4.37 mg/L), and PCT(0.10 vs 0.04 ng/mL) levels were considerably greater in NHL cases with respiratory bacterial infections relative to NHL cases without infection (P<0.05). Furthermore, IL-6(145.00 vs 41.67 pg/mL), IL-8(34.60 vs 15.55 pg/mL),temperature(38.4 vs 37.6°C), PCT(0.79 vs 0.10 ng/mL), and CRP(93.70 vs 20.80 mg/L) levels in respiratory infectious NHL patients with more severe bacteremia were considerably elevated than in patients with respiratory bacterial infections only (P<0.05). Remarkably, increased levels of IL-6 and IL-8 are effective in determining whether or not pulmonary bacterial infectious NHL patients have bacteremia. Temperature, PCT, and CRP all have lower sensitivity and specificity than IL-6. IL-6 ≥18.79pg/mL indicates the presence of pulmonary bacterial infection in newly diagnosed NHL patients, and IL-6 ≥102.6pg/mL may suggest pulmonary bacterial infection with bacteremia. In short, this study shows that cytokines can be advantageous in the diagnosis and differentiation of pulmonary bacterial infection and bacteremia in newly diagnosed NHL patients and may also guide for the use of clinical antibiotics.

非霍奇金淋巴瘤（Non-Hodgkin’s lymphoma, NHL）是一类起源于淋巴组织的肿瘤。NHL患者群体中细菌感染极为常见。由于多数患者在感染初期无明显临床症状，因此在病情进展至危重阶段前，难以对该潜在感染状态作出早期诊断。细胞因子活化是炎症反应的标志性特征。鉴于细胞因子检测具备耗时短、灵敏度高的优势，诸多研究均围绕细胞因子与感染的关联展开，但针对合并感染的NHL患者的相关研究仍较为匮乏。为此，本研究回顾分析了229例初诊NHL患者与40名健康成人的细胞因子谱数据，旨在预测呼吸性细菌感染与菌血症的发生风险。研究结果显示，相较于未合并感染的NHL患者，合并呼吸性细菌感染的NHL患者的白细胞介素6（IL-6，41.67 vs 9.50 pg/mL）、白细胞介素8（IL-8，15.55 vs 6.61 pg/mL）、白细胞介素10（IL-10，8.02 vs 4.52 pg/mL）、肿瘤坏死因子β（TNF-β，3.82 vs 2.96 pg/mL）、干扰素γ（IFN-γ，4.76 vs 2.96 pg/mL）、体温（37.6 vs 36.5℃）、C反应蛋白（CRP，20.80 vs 4.37 mg/L）以及降钙素原（PCT，0.10 vs 0.04 ng/mL）水平均显著升高（P<0.05）。进一步分析发现，相较于仅合并呼吸性细菌感染的NHL患者，伴重症菌血症的呼吸感染性NHL患者的白细胞介素6（IL-6，145.00 vs 41.67 pg/mL）、白细胞介素8（IL-8，34.60 vs 15.55 pg/mL）、体温（38.4 vs 37.6℃）、降钙素原（PCT，0.79 vs 0.10 ng/mL）以及C反应蛋白（CRP，93.70 vs 20.80 mg/L）水平同样显著升高（P<0.05）。值得注意的是，白细胞介素6与白细胞介素8水平升高可有效鉴别合并菌血症的肺部细菌性感染NHL患者。相较于白细胞介素6，体温、降钙素原与C反应蛋白的诊断灵敏度与特异度均更低。当白细胞介素6水平≥18.79pg/mL时，提示初诊NHL患者合并肺部细菌性感染；而当白细胞介素6水平≥102.6pg/mL时，则可能提示患者同时合并肺部细菌性感染与菌血症。综上，本研究表明，细胞因子谱可用于初诊NHL患者肺部细菌性感染与菌血症的诊断及鉴别诊断，同时可为临床抗菌药物的合理使用提供指导依据。