The significance of serum beta-2 microglobulin (sβ2m) in Hodgkin lymphoma (HL) is controversial. We analyzed 915 patients with HL, who were treated with ABVD or equivalent regimens with or without radiotherapy. Sβ2m levels were measured by a radioimmunoassay (upper normal limit 2.4 mg/L). Sequential cutoffs (1.8–3.0 by 0.1 mg/L increments, 3.5 and 4.0 mg/L) were tested along with ROC analysis. The median sβ2m levels were 2.20 mg/L and were elevated (>2.4 mg/L) in 383/915 patients (41.9%). Higher sβ2m was associated with inferior freedom from progression (FFP) at all tested cutoffs. The best cutoff was 2.0 mg/L (10-year FFP 83% vs. 70%,p= 0.001), which performed better than the 2.4 mg/L cutoff (“normal versus high”). In multivariate analysis, sβ2m > 2.0 mg/L was an independent adverse prognostic factor in the whole patient population. In multivariate overall survival analysis, sβ2m levels were predictive at 2.0 mg/L cutoff in the whole patient population and in advanced stages. Similarly, sβ2m > 2.0 mg/L independently predicted inferior HL-specific survival in the whole patient population. Our data suggest that higher sβ2m is an independent predictor of outcome in HL but the optimal cutoff lies within the normal limits (i.e., at 2.0 mg/L) in this predominantly young patient population, performing much better than a “normal versus high” cutoff set at 2.4 mg/L.
血清β2微球蛋白(sβ2m)在霍奇金淋巴瘤(HL)中的意义存在争议。我们分析了915例接受ABVD或等效方案联合或不联合放疗治疗的HL患者。采用放射免疫分析法测定sβ2m水平(正常上限为2.4 mg/L)。通过ROC分析测试了系列临界值(1.8–3.0 mg/L，以0.1 mg/L递增，以及3.5和4.0 mg/L)。sβ2m中位水平为2.20 mg/L，383/915例患者(41.9%)水平升高(>2.4 mg/L)。在所有测试临界值下，较高的sβ2m均与较差的疾病无进展生存期(FFP)相关。最佳临界值为2.0 mg/L(10年FFP 83% vs. 70%，p=0.001)，其预测效能优于2.4 mg/L临界值(“正常与升高”)。多变量分析显示，在整个患者群体中，sβ2m > 2.0 mg/L是独立的不良预后因素。在多变量总生存分析中，sβ2m水平以2.0 mg/L为临界值在整个患者群体及晚期患者中具有预测价值。同样，sβ2m > 2.0 mg/L在整个患者群体中独立预测较差的HL特异性生存。我们的数据表明，较高的sβ2m是HL预后的独立预测因子，但在这个以年轻患者为主的群体中，最佳临界值位于正常范围内(即2.0 mg/L)，其预测效能显著优于设定在2.4 mg/L的“正常与升高”临界值。
肿瘤(癌症)患者之家