Objective To investigate the significance of serum CD25 / serum ferritin in the diagnosis of lymphoma-associated hemophagocytic syndrome (LAHS),so as to provide the clinical basis for improving its recognition and giving effective therapy. Methods The serums were collected from 70 patients with hemophagocytic syndrom in Beijing Friendship Hospital, Capital Medical University during the period from October 2008 to June 2011, including 31 LAHS cases and 39 other disease-associated HPS cases. The serum CD25 level in HPS patients was measured with enzyme-linked immunosorbent assay (ELISA), and the serum ferritin was measured on the same day. Then the serum CD25/ferritin ratio was calculated and the differences of the serum CD25, serum ferritin and serum CD25/ferritin ratio between two groups were compared. Results The variance of serum CD25 [(15760.52±7851.74) pg/ml vs (12727.41±11285.28) pg/ml,t=-1.78,P=0.075] and serum ferritin levels (1750.00 ng/ml vs 2947.00 ng/ml,Z=-1.490,P=0.136)were not statistically significant between two groups,while the serum CD25/serum ferritin ratio in LAHS patients was significantly higher than the other group(8.57×10-3 vs 2.84×10-3,Z=-2.106,P=0.035).Conclusion The serum CD25/ serum ferritin ratio is statistically higher in LAHS patients, which might be a novel useful marker for predicting underlying malignant lymphoma in HPS patients.

In order to investigate the expression of serum sHLA-G in hemophagocytic syndrome (HPS) patients and to evaluate its clinical significance, the clinical data of HPS patients in Capital Medical University Beijing Friendship Hospital during the period from September 2008 to July 2010 were collected. They were divided into infection-associated HPS, tumor-associated HPS and rheumatological disease-associated HPS according to cause of diseases. The serum concentration of sHLA-G in HPS patients and 25 healthy controls was measured by enzyme-linked immunosorbent assay (ELISA), the correlations between sHLA-G level and laboratory indicators were analyzed. The results showed that the level of serum sHLA-G in HPS patients was significantly higher than that in healthy controls (p = 0.003), but the difference was not statistically significant between HPS groups of different causes (p = 0.233). The positive correlation of sHLA-G level in HPS patients with platelet count was found, but there was no positive correlation of their sHLA-G levels with WBC, Hb, Plt, ALT, AST, LDH, Alb, TBil, DBil, IBil, Cr, BUN, TG, fibrinogen and ferritin levels detected on same day. It is concluded that the the increase of serum sHLA-G levels in HPS patients may be caused by different factors such as infection, tumor, T cell activation and over-stimulation of several cytokines. sHLA-G can inhibit NK cell activity, resulting in formation of abnormal immune storm, and may be play a role in the pathogenesis of HPS.
Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Female ; HLA-G Antigens ; blood ; Humans ; Killer Cells, Natural ; metabolism ; Lymphohistiocytosis, Hemophagocytic ; blood ; Male ; Middle Aged ; Young Adult

OBJECTIVEThrough monitoring esophageal dynamic change, and detection of laryngopharyngeal reflux(LPR) and gastroesophageal reflux events,to discuss the relationship of vocal cord polyps with laryngopharyngeal reflux.

METHODSThirty-two patients with vocal cord polyps were diagnosed by electronic laryngoscopy in Nanfang Hospital between October 2011 to May 2012. This study applied high-resolution esophageal manometry (HRM) and ambulatory 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH) to obtain the upper esophageal sphincter(UES) and lower esophageal sphincter pressure, characteristics of sectional esophageal motility; laryngopharyngeal reflux (LPR)and gastroesophageal reflux events, as well as the reflux properties of substances. Sixteen healthy volunteers were recruited as normal controls.

RESULTSUES relaxation duration, duration of UES relaxation time, UES relaxation recovery time and mean length of LES were all shorter than those of the control group (t were 2.244, 2.624, 2.310 and -2.397, P < 0.05). There were 40.6% (13/32) LPR and 50.0% (16/32) gastroesophageal reflux found in vocal polyp patients. Median number (M [P25; P75]) of laryngopharyngeal acid reflux events were 0.5[0.0;3.5] and 0.0[0.0;0.0] in vocal polyp group and the controls, median mean time of laryngopharyngeal acid exposure 0.1[0.0;1.7] and 0.0[0.0;0.0] min, median clearance time of laryngopharyngeal acid were 3.5[0.0;53.5] and 0.0[0.0;0.0] s, median scores of DeMeester were 14.8[1.6;31.3] and 1.8[1.1;4.1] and median frequency of total liquid reflux episodes were 46.5[25.3;69.0] and 32.5[20.0;36.3], respectively. The median numbers of laryngopharyngeal acid reflux events, time of acid exposure, time of acid clearance, DeMeester scores and frequency of total liquid reflux episodes were increased or higher in vocal polyp group than those in the controls (z were 2.481, 2.767, 2.767, 2.344 and 1.980, P < 0.05).

CONCLUSIONSThere are upper esophageal sphincter and Lower esophageal sphincter dismotility in vocal polyp patients with LPR. LPR events were dominated by acid reflux in upright position.Esophageal dynamic disfunction and LPR should be considered in the study of the pathogenesis of vocal cords polyps.

Electric Impedance ; Esophageal Sphincter, Lower ; Esophageal pH Monitoring ; Gastroesophageal Reflux ; diagnosis ; Humans ; Laryngeal Diseases ; diagnosis ; Laryngopharyngeal Reflux ; diagnosis ; Laryngoscopy ; Manometry ; Polyps ; diagnosis ; Vocal Cords