| Objection:To study the impact of inflammatory tumor microenvironment on tumor-associated thrombophilia by observing the expression of tumor-associated macrophages (TAMs), and inflammatory cytokines in lymph node pathology, and the expression level of plasma coagulation index, and serum inflammatory cytokines in patients with lymphoma.Methods:106 cases of clinical pathology specimens of patients with newly diagnosed lymphoma were collected in Subei People’s Hospital of Jiangsu province between 2009-2014. There were 61 cases of diffuse large B-cell lymphoma (difiuse large B cell lymphoma DLBCL), including 17 cases of GCB,54 cases of DLBCL non-GCB; 10 cases of mantle cell lymphoma MCL; 14 cases of NK/T cell lymphoma (NK/T cell lymphoma NKTL); 11 cases of Hodgkin’s lymphoma (Hogkin lymphoma, HL).Reference to the diagnostic criteria of AnnArbor staging and systemic symptoms, these cases were classified into Phase Ⅱ,Ⅲ,Ⅳ period and symptomatic group stage, and asymptomatic group. According to the classification of International Prognostic Index (IPI), all cases were divided into low-risk group, low-intermediate risk group, high-intermediate risk group, and high-risk group. The expression tumor-associated macrophages observed indicators (CD68), colony stimulating factor-1 receptor (CSF-1R), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), interleukin-1β (IL-1β) and other inflammatory cytokines in lymphoma tissue samples were detected by immunohistochemical staining; the level of serum C-reactive protein(CRP) was measured by rate method; and the expression level of plasma D-dimer (D-dimer, DD), von Willebrand factor (von Willebrand factor, vWF), fibrinogen (fibrinogen, FIB) and levels of antithrombin-Ⅲ (AT-Ⅲ, AT) were detcted by magnetic beads.Results1. CD68 and CSF-1R showed high expression in lymphoma tumor tissue. The positive rate of CD68 and CSF-1R in Ⅳ period patients was higher than Ⅱ period (P<0.05), an the expression level of CSF-1Rin high-risk group was higher than low-risk group (P<0.05). The expression of CD68 was positively correlated with CSF-1R2. IL-1β, TNF-a, IL-6, IL-10 were high expresseded in Lymphoma tumor tissue; the positive rate of IL-1β in lymphoma IV period was higher than period II (P<0.05), the expression level of IL-6 expression in high-risk group were significantly higher than low-risk group (P<0.05).3. The expression of tumor-associated macrophage phenotype CD68 in lymphoma tissue was positively correlated with inflammatory cytokines IL-1β,TNF-α, and IL-6(P<0.05).4. The level of plasma coagulation indexes FIB, D-D, and vWF were higher than the control group, while the level of AT was lower than the control group(P<0.05). The level of coagulation parameters in lymphoma Ⅳ stage were higher than the II stage (P<0.05); the level of FIB in high-risk group was significantly higher than the low-intermediate risk group and low risk group(P<0.05);the symptomatic group was higher than the asymptomatic group (P<0.05).5. The level of CRP in patients with lymphoma was higher than the control group (P<0.05). The level of CRP in high-risk group, high-intermediate risk group, the low-intermediate risk group were higher than in the low-risk group (P<0.05), The CRP in symptomatic group was higher than the asymptomatic group (P<0.05).6. The expression level of CRP were positively correlated with plasma coagulation factor FIB, D-D, and vWF, and negatively correlated with AT.7. The expression of D-D, vWF levels in the tumor-associated macrophage phenotype CD68 high expressed group were significantly higher than the low expressed group (P<0.05); and the level of AT decreased more significantly (P<0.05).Conclusion1. Tumor-associated macrophage phenotype CD68, CSF-1R were high expressed in lymphoma tissue;2. The expression of CD68 in organization was correlated with inflammatory cytokines, suggesting TAMs were involved in tumor inflammatory microenvironment;3. The expression of CD68, CSF-1R were correlated with plasma coagulation indexas as tumor-associated thrombophilia4. Tumor-associated thrombophilia can be effectively monitored by D-D, AT, vWF, and FIB.
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