| Background: Hydrogen sulfide（H2S）,Nitric oxide（NO）and Carbon monoxide（CO）are three kinds of gas messenger molecules discovered by human beings.They regulate the physiological function of various organ systems.Their metabolic abnormalities in the body are closely related to the outcome of many clinical diseases.The results of the present study show that the levels of endogenous H2S,NO and CO in the development of many malignant tumors such as leukemia,lung cancer and liver cancer have changed.In the early stage of this project,we found that patients with acute promyelocytic leukemia Plasma H2S levels were elevated and the treatment was relieved.The exogenous H2S could promote the proliferation of cultured HL-60 cells.It was proved that endogenous H2S was involved in the pathogenesis of acute promyelocytic leukemia.At the same time we also think the other blood system malignant tumor,blood H2S concentration may also be changed,and NO & CO changes in the trend may be consistent.Because diffuse large B cell lymphoma（DLBCL）is the most common non-Hodgkin’s lymphoma in adults,the study of it is of great clinical significance,so we designed this subject to investigate the changes and clinical significance of H2S,NO and CO in the blood of patients with diffuse large B cell lymphoma.In our country,for the treatment of DLBCL,chemotherapy is still the most important treatment,with the application of new drugs,the total efficiency and 5-year survival rate has been significantly improved,but still did not achieve the desired state,so before and after treatment Prognostic assessment is very important,the current internationally recognized method is the use of International Prognostic Index（IPI）.To assess the study,we will further study the plasma H2S,NO and CO levels and the relationship between IPI score,thatis,IPI score as a reference to explore the role of gas signaling molecules in the prognosis of DLBCL,with a view to seeking new indicators for the IPI scoring system.Objective:1 To study the changes and clinical significance of plasma H2S,NO and CO concentrations in patients with diffuse large B-cell lymphoma before and after treatment,and to explore the relationship between plasma H2S,NO and CO levels and IPI scores.2 To explore the clinical significance of H2S,NO and CO in the prognosis of diffuse large B cell lymphoma.Methods:1 Patients were selected: the observation group for the hospital diagnosis and treatment of 36 patients,all patients were biopsy,pathology and immunohistochemistry confirmed DLBCL cases,including 20 males and 16 females,aged 30-78 Age,their average age of 56 years.These DLBCL cases,the first onset of treatment to our hospital,did not receive radiotherapy and chemotherapy and other treatment methods,and does not merge autoimmune diseases,obvious infection,other benign and malignant tumors,blood system,severe heart,lung,liver and kidney dysfunction and so on.According to IPI score,0-1 points in 10 cases（Low risk group）,2points in 9 cases（Low intermediate risk group）,3 points in 11 cases（High intermediate risk group）,4-5 points in 6 cases（High risk group）.30 cases of the control group for the same time in our hospital physical examination center health examination.There was no significant difference in sex,age,liver and kidney function between the selected DLBCL cases and the control group（P>0.05）.The research program was carried out with the consent of our institute’s ethics committee.2 To determine the concentration of H2S in plasma: The observation group before and after chemotherapy in the morning fasting venous blood2 mL EDTA-K2 in test tube,in the low temperature centrifuge with 3000 r /min 10min（r=13.5）,centrifugal separation of plasma,to EP tube,sealedinto the refrigerator to be measured in-70℃.DLBCL patients after chemotherapy complete remission and then blood.The specimen collection and processing methods of the normal control group were the same as those of the observation group.Plasma H2S levels were measured by spectrophotometer.3 The determination of plasma NO: In the observation group before and after chemotherapy in the morning fasting venous blood 2mL in heparin in a test tube in a low-temperature centrifuge at 3000 r/min for 10 min,removing the plasma in an EP tube,is sealed into the-70℃refrigerator to be tested prior to the assay samples at room temperature after melting,3000 rpm for 10 minutes,the supernatant was determined.The level of serum NO was measured by nitric oxide Kit（Nitrate reductase method）.4 The determination of plasma CO: Observation group and control group in the morning fasting state,draw venous blood of 2mL in the low temperature centrifuge centrifuge at 3000 r/min for 10 min,removing the plasma in an EP tube,is sealed into the-70℃ refrigerator to be tested prior to the assay samples at room temperature Furong after 3000 rpmfor 10 minutes,the supernatant was determined.Using Chalmers and hemoglobin binding two sulfite reduction method in determination of plasma CO level.5 Data processing and statistical analysis of the changes of H2S,NO and CO in blood before and after chemotherapy.Results:1 Patients with diffuse large B cell lymphoma before treatment of plasma H2S levels was significantly increased（P<0.01）;the level of H2S in plasma decreased significantly after remission（P<0.01）;H2S is involved in the pathophysiology of patients with diffuse large B cell lymphoma.2 Patients with diffuse large B cell lymphoma before treatment of plasma NO levels was significantly increased（P<0.01）;the level of NO in plasma decreased significantly after remission（P<0.01）;H2S is involved in the pathophysiology of patients with diffuse large B cell lymphoma.3 Patients with diffuse large B cell lymphoma before treatment of plasma CO levels was significantly increased（P<0.01）;the level of CO in plasma decreased significantly after remission（P<0.01）;CO is involved in the pathophysiology of patients with diffuse large B cell lymphoma.4 The changes of plasma H2S,NO and CO levels in patients with diffuse large B cell lymphoma were consistent,H2S was positively correlated with NO and CO,before treatment（r=0.807,0.788,P<0.01）,After complete remission（r=0.746,0.691,P <0.01）.5 The levels of H2S,NO and CO in IPI4-5 group were higher than those in IPI0-1,2 and 3.The difference was statistically significant（P<0.05,P<0.01）.The levels of H2S,NO and CO in IPI3 group were higher than those in IPI0-1 group.The difference was statistically significant（P<0.01）.Conclusion:1 H2S,NO and CO in diffuse large B cell lymphoma in patients before treatment of plasma were increased by H2S,NO and plasma CO levels decreased significantly after remission;three participated in the pathophysiological process of patients with diffuse large B cell lymphoma.2 The changes of H2S,NO and CO levels in plasma of patients with diffuse large B cell lymphoma may be associated with each other,H2S was positively correlated with NO and CO.3 The concentration of H2S,NO and CO in plasma of patients with diffuse large B cell lymphoma was positively correlated with the IPI score,which could help to judge the prognosis of the disease. |
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