Objective: To investigate the significance of plasma pentraxin 3 (PTX3) in patients with secondary hemophagocytic lymphohistiocytosis (sHLH). Methods: Plasma PTX3 levels were tested by ELISA in 48 newly diagnosed sHLH patients, 18 healthy volunteers and 9 lymphoma controls in the First Affiliated Hospital of Nanjing Medical University from January 2017 to July 2019. Clinical parameters were collected, and the correlations with PTX3 levels were analyzed. Results: PTX3 level in newly diagnosed group was significantly higher than that of healthy control group [16.29(1.17-66.00) vs. 0.76(0.01-7.86) μg/L, P<0.01]. Patients with lymphoma-associated HLH(LHLH) had higher plasma level of PTX3 than Fhose with infection-associated HLH (IHLH) [24.29(3.36-66.00) vs. 9.56(1.17-36.50)μg/L, P<0.05]. Plasma PTX3 levels in 48 sHLH patients were positively correlated with serum ferritin (P<0.05). Receiver operating characteristic (ROC) curve for plasma PTX3 levels of sHLH and healthy controls produced a cutoff value at 3.9 μg/L, with its 86.7% sensitivity and 94.4% specificity. And ROC analysis showed that PTX3 17.5 μg/L was the critical value for diagnosis of LHLH from non-LHLH group, that the sensitivity and specificity were 63.0% and 76.2% respectively. The 1-year overall survival (OS) rate in patients with PTX3≥17.5 μg/L was significantly lower in those with PTX3<17.5 μg/L (18.5% vs. 75.8%, P<0.01). Conclusion: These results indicate the potential of PTX3 as a biomarker for diagnosis and prognosis in patients with sHLH.
目的： 探讨血浆PTX3在继发性噬血细胞性淋巴组织细胞增多症（sHLH）的表达水平及其临床意义。 方法： 回顾性分析2017年1月至2019年7月南京医科大学第一附属医院48例sHLH患者外周血浆标本，以18名健康体检者、9例淋巴瘤患者为对照，ELISA法检测血浆PTX3水平。收集患者相关实验室检查数据，并根据血浆PTX3的表达水平进行诊断及预后分析等。 结果： 初诊sHLH组血浆PTX3表达水平明显高于健康对照组[16.29（1.17~66.00）比0.76（0.01~7.86）μg/L, P<0.01]；初诊淋巴瘤相关HLH组（LHLH）血浆PTX3水平明显高于感染相关HLH组（IHLH）[24.29（3.36~66.00）比9.56（1.17~36.50）μg/L, P<0.05]。48例sHLH患者血浆PTX3水平与血清铁蛋白正相关（P<0.05）。血浆PTX3以3.9 μg/L为最佳临界值时，其判断sHLH患者及健康对照组的敏感度及特异度分别为86.7%及94.4%；血浆PTX3以17.5 μg/L为最佳临界值时，其判断LHLH组与non-LHLH组的敏感度及特异度分别为63.0%及76.2%。对初诊sHLH组进行预后分析，多因素分析显示PTX3≥17.5 μg/L组1年总生存率（18.5%）与PTX3<17.5 μg/L组（75.8%）相比，差异有统计学意义（P<0.01）。 结论： 血浆PTX3在sHLH患者的诊断、LHLH鉴别诊断、预后分析等方面具有重要的临床意义。.
Keywords: Lymphohistiocytosis, hemophagocytic; Polyproteins; Prognosis.