Objective: To evaluate the expression of interleukin-6 (IL-6) and its clinicopathological significance in Castleman's disease (CD).
Methods: 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.
Results: 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).
Conclusion: 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.
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。