Objective: To investigate the significance of antinuclear antibody and antinuclear antibody spectrum in the stage and prognosis of lymphoma patients.
Methods: 79 cases of lymphoma (lymphoma group) treated in the Second Affiliated Hospital of Fujian Medical University and 50 cases of healthy people (control group) were selected. Antinuclear antibodies (ANA) were detected by indirect innmunofluorescence and ANA spectrums were detected by linear Western blot, the expression level of ANA and ANA spectrum in the two groups were analyzed. The lymphoma group was divided into the positive and the negative group according to ANA level, the levels of lactate dehydrogenase (LDH), white blood cell (WBC), disease type, stage and prognosis of the two groups were compared.
Results: In the lymphoma group, the positive rate of ANA was 48.1%, while the positive rate was 8.0% in the health control group, both of them showed statistically significant (χ2=22.42, P＜0.05). ANA fluorescence karyotype in lymphoma group was mainly speckle type. In the Lymphoma group, the positive rate of ANA spectrum was 29.1%, while the positive rate in the control group was 4.0%, both of them showed statistically significant (χ2=12.36, P＜0.05). The target antigen distribution of ANA spectrum in the lymphoma group was relatively complex, mainly RO52 and SSA, while that in the control group was simple. The positive rate of ANA in lymphoma patients showed increased with age, the titer was mainly 1∶100 low titer positive, the positive rate of ANA in female patients was higher than that in male patients; The average count±standard deviation of LDH and WBC in the ANA positive and negative group were (253.67±255.85) U/L, (218.18±208.34) U/L, (6.34±3.31)×109/L and (6.81±3.91)×109/L respectively, which showed no statistical significance between the two groups (t=0.59 P＞0.05; t=0.57 P＞0.05); B-cell lymphoma was the main disease in both groups, which accounted for 81.6% (31/38) and 68.3% (28/41) respectively; while in B-cell lymphoma, diffuse large B-cell lymphoma was the main lymphoma. For the patients with B-cell lymphoma, the patients at stage IV in ANA positive group was 58.1% (18/31), while that in the ANA negative group was 28.6% (8 / 28), and both of them showed statistically significant (χ2=5.19, P＜0.05). Follow-up showed that the survival rate of the patients in ANA negative group was higher than that in ANA positive group, which showed statistically significant difference (P＜0.05).
Conclusion: The postive rate of antinuclear antibody and antinuclear antibody spectrum are higher in lymphoma patients, which have considerable significance for the stage and prognosis of lymphoma treatment.
题目: 抗核抗体与抗核抗体谱在淋巴瘤治疗中的应用.
目的: 探讨抗核抗体与抗核抗体谱在淋巴瘤分期及患者预后中的意义.
方法: 选取在福建医科大学附属第二医院就诊的淋巴瘤患者79例(淋巴瘤患者组)以及健康体检对照者50例（对照组），用间接免疫荧光法检测抗核抗体(antinuclear antibodies，ANA)，同时用免疫印迹法检测抗核抗体谱(ANA谱)，分析2组ANA、ANA谱的表达水平；淋巴瘤组再按ANA水平分为阳性组和阴性组，比较两组的乳酸脱氢酶（lactate dehydrogenase，LDH）、白细胞(white blood cell，WBC)数的水平、疾病的分型、分期以及患者预后情况.
结果: 淋巴瘤组中，ANA的阳性率为48.1%，健康体检对照组阳性率为8.0%，两者有统计学意义（χ2=22.42，P＜0.05），淋巴瘤组ANA荧光核型以颗粒型为主；淋巴瘤组中ANA谱的阳性率为29.1%，对照组为4.0%，2者有统计学意义（χ2=12.36，P＜0.05），淋巴瘤组ANA谱的靶抗原分布比较复杂，以RO52、SSA为主，而对照组的分布比较简单；淋巴瘤患者ANA的阳性率随着年龄增长有增高趋势，滴度以1∶100的低滴度阳性为主，女性患者ANA阳性率高于男性；淋巴瘤ANA阳性组和ANA阴性组LDH、WBC数平均值±标准差分别为（253.67±255.85）U/L、（218.18±208.34）U/L、（6.34±3.31）×109/L、（6.81±3.91）×109/L，2组间均无统计学意义（t=0.59 P＞0.05；t=0.57 P＞0.05）；ANA阳性组与阴性组疾病诊断均以B细胞淋巴瘤为主，分别占81.6%（31/38）、68.3%（28/41）；而B细胞淋巴瘤中均以弥漫大B细胞淋巴瘤为主；在B细胞淋巴瘤患者中，ANA阳性组Ⅳ期的患者为58.1%（18/31），阴性组Ⅳ的患者为28.6%（8/28），两者有统计学意义（χ2=5.19，P＜0.05）；随访显示，淋巴瘤ANA阴性组的生存率高于ANA阳性组，差异有统计学意义（P＜0.05）.
结论: 淋巴瘤患者中抗核抗体、抗核抗体谱的阳性率较高，对淋巴瘤的分期以及预后判断有一定的意义.