急性白血病患者T、B淋巴细胞的检测与分析
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摘要
目的:探讨不同类型的急性白血病患者外周血T淋巴细胞亚群、B淋巴细胞和NK细胞等在疾病的不同时期的变化及其临床意义。方法:采用流式细胞术检测95例初诊白血病患者[急性淋巴细胞白血病(ALL)43例,急性髓系白血病(AML)52例]诱导治疗前后及50例正常对照者外周血T淋巴细胞亚群、B淋巴细胞、NK细胞及Treg细胞百分比。结果:初诊白血病各组CD3~+、CD3~+CD4~+、CD3~+CD8~+、NK细胞阳性率和CD4~+/CD8~+比值均明显低于正常对照组(P<0.05),治疗后完全缓解患者的上述指标均明显高于治疗前(P<0.05)。初诊白血病各组患者Treg细胞阳性率均高于正常对照组(P<0.01),AML和ALL治疗组完全缓解患者Treg细胞阳性率较治疗前有所降低(P<0.05)。AML初诊组CD3-CD19~+细胞阳性率明显低于正常对照组(P<0.01),ALL初诊组CD3-CD19~+细胞阳性率高于正常对照组(P<0.01);治疗后AML组缓解患者CD3-CD19~+细胞阳性率高于治疗前(P<0.05),ALL组缓解患者CD3-CD19~+细胞阳性率明显低于治疗前(P<0.01);ALL治疗后未缓解者CD3-CD19~+细胞阳性率明显低于治疗前(P<0.01);ALL治疗后未缓解者的其余各项指标及AML治疗后未缓解者各项指标与治疗前比较无统计学差异。结论:初诊白血病各组T淋巴细胞亚群、B淋巴细胞和NK细胞的变化明显,完全缓解组的上述指标基本恢复正常,说明T淋巴细胞亚群、B淋巴细胞、NK细胞水平检测在评价急性白血病严重程度、疗效及判断患者预后有一定的临床价值。
Objective: To investigate the changes of T lymphocyte subsets, B lymphocyte and NK cells in peripheral blood of patients with acute leukemia at different periods and their significance. Methods: The peripheral T lymphocyte subsets and B lymphocyte of 95 patients with acute leukemia [(43 cases of acute lymphoblastic leukemia(ALL), 52 cases of acute myeloid leukemia(AML)] and 50 normal people were detected by flow cytometry respectively. Results:The positive rate of CD3~+, CD3~+CD4~+, CD3~+CD8~+, NK cells and CD4~+/CD8~+ in the patients with newly diagnosed acute leukemia were significantly lower than those in normal controls(P<0.05), but increased obviously after complete remission. The positive rate of Treg cells in the patients with newly diagnosed leukemia group was significantly higher than that in normal controls(P<0.01), but decreased obviously after complete remission. Positive rate of CD3-CD19~+cells in the patients with newly diagnosed acute myeloid leukemia was significantly lower, but higher in the patients with newly diagnosed acute lymphoblastic leukemia than that in normal controls with statistical significant difference(P<0.05), and increased obviously in the patients with acute myeloid leukemia(P<0.05) after complete remission, but decreased in the patients with acute lymphoblastic leukemia(P<0.01) after complete remission or no-remission. Conclusion:Changes of T lymphocyte subsets, B lymphocytes and NK cells in the patients with newly diagnosed acute leukemia are significant, thus the detection of T lymphocyte cell subsets, B lymphocytes and NK cells can provide some evidences. for evaluation of the disease severity, curative efficiency and prognosis of patients with acute leukemia.
Objective: To investigate the changes of T lymphocyte subsets, B lymphocyte and NK cells in peripheral blood of patients with acute leukemia at different periods and their significance. Methods: The peripheral T lymphocyte subsets and B lymphocyte of 95 patients with acute leukemia [(43 cases of acute lymphoblastic leukemia(ALL), 52 cases of acute myeloid leukemia(AML)] and 50 normal people were detected by flow cytometry respectively. Results:The positive rate of CD3~+, CD3~+CD4~+, CD3~+CD8~+, NK cells and CD4~+/CD8~+ in the patients with newly diagnosed acute leukemia were significantly lower than those in normal controls(P<0.05), but increased obviously after complete remission. The positive rate of Treg cells in the patients with newly diagnosed leukemia group was significantly higher than that in normal controls(P<0.01), but decreased obviously after complete remission. Positive rate of CD3-CD19~+cells in the patients with newly diagnosed acute myeloid leukemia was significantly lower, but higher in the patients with newly diagnosed acute lymphoblastic leukemia than that in normal controls with statistical significant difference(P<0.05), and increased obviously in the patients with acute myeloid leukemia(P<0.05) after complete remission, but decreased in the patients with acute lymphoblastic leukemia(P<0.01) after complete remission or no-remission. Conclusion:Changes of T lymphocyte subsets, B lymphocytes and NK cells in the patients with newly diagnosed acute leukemia are significant, thus the detection of T lymphocyte cell subsets, B lymphocytes and NK cells can provide some evidences. for evaluation of the disease severity, curative efficiency and prognosis of patients with acute leukemia.
引文
1甄祯,叶芳,李国霞,等.恶性血液病患者T淋巴细胞亚群的检测分析.中国当代医药, 2014; 21(9):101-102.
2 孙鸿丽,张浪辉,王婧. Treg细胞、NK细胞及T淋巴细胞亚群的水平变化对急性白血病的临床诊治意义评价.临床血液学杂志, 2016; 29(5):741-743.
3 原永明,程丽,张舒,等.白血病治疗前后CD3+、CD3+CD4+、CD3+CD8+T细胞的变化及意义.检验医学, 2016; 31(5):387-391.
4 叶芳,张莉萍.输注红细胞对恶性血液病患者T淋巴细胞亚群的影响.中国实验血液学杂志, 2016; 24(5):1577-1582.
5 张司琪,葛健,夏瑞祥.急性白血病患者外周血T细胞亚群、NK细胞和调节性T细胞的检测及临床意义.安徽医科大学学报, 2016; 51(2):218-221.
6 王平忠,于海涛,蒋伟,等.自然杀伤细胞受体介导抗病毒免疫的分子机制.细胞与分子免疫学杂志, 2013; 29(4):441-443.
7 陆春伟,佟海侠,陆美言.急性白血病患者外周血淋巴细胞亚群和调节性T细胞的检测及临床意义.现代肿瘤医学, 2010;18(11):2230-2233.
8 徐华,王丹波.诱导调节性T细胞与肿瘤免疫研究进展.免疫学杂志, 2015;31(4):353-357.
9 Beyer M, Schultze JL. Regulatory T cells in cancer. Blood, 2006;108(3):804-811.
10 吴朝阳,吴雅荣,王法春,等.急性白血病患者外周血T淋巴细胞亚群和NK细胞水平检测及临床意义.江苏大学学报(医学版), 2008; 18(5):432-434.
2 孙鸿丽,张浪辉,王婧. Treg细胞、NK细胞及T淋巴细胞亚群的水平变化对急性白血病的临床诊治意义评价.临床血液学杂志, 2016; 29(5):741-743.
3 原永明,程丽,张舒,等.白血病治疗前后CD3+、CD3+CD4+、CD3+CD8+T细胞的变化及意义.检验医学, 2016; 31(5):387-391.
4 叶芳,张莉萍.输注红细胞对恶性血液病患者T淋巴细胞亚群的影响.中国实验血液学杂志, 2016; 24(5):1577-1582.
5 张司琪,葛健,夏瑞祥.急性白血病患者外周血T细胞亚群、NK细胞和调节性T细胞的检测及临床意义.安徽医科大学学报, 2016; 51(2):218-221.
6 王平忠,于海涛,蒋伟,等.自然杀伤细胞受体介导抗病毒免疫的分子机制.细胞与分子免疫学杂志, 2013; 29(4):441-443.
7 陆春伟,佟海侠,陆美言.急性白血病患者外周血淋巴细胞亚群和调节性T细胞的检测及临床意义.现代肿瘤医学, 2010;18(11):2230-2233.
8 徐华,王丹波.诱导调节性T细胞与肿瘤免疫研究进展.免疫学杂志, 2015;31(4):353-357.
9 Beyer M, Schultze JL. Regulatory T cells in cancer. Blood, 2006;108(3):804-811.
10 吴朝阳,吴雅荣,王法春,等.急性白血病患者外周血T淋巴细胞亚群和NK细胞水平检测及临床意义.江苏大学学报(医学版), 2008; 18(5):432-434.