非霍奇金淋巴瘤患者外周血CD4^+CD25^(high)CD127^(low)调节T细胞水平及其与临床特点的关系

Correlation between peripheral blood CD4^+CD25^(high) CD127^(low) regulatory T cell and clinical characteristics of patients with non-Hodgkin's lymphoma

背景与目的:有关非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)与免疫抑制状态的研究引起人们的关注。调节T细胞(regulatory T cell,Treg)是免疫抑制细胞,Treg与淋巴瘤之间的关系存在争议。本研究检测初诊NHL患者及正常人外周血Treg水平,探讨外周血Treg与NHL的关系。方法:选取中山大学肿瘤防治中心2006年12月至2008年3月收治的99例初诊NHL患者及31例体检正常的健康成人的外周血标本,采用流式细胞仪联合标记CD4、CD25、CD127检测NHL患者及健康成人外周血CD4+CD25highCD127low Treg水平并进行分析。结果:正常人外周血CD4+CD25highCD127low Treg水平为8.07±1.90,初诊NHL患者外周血CD4+CD25highCD127low Treg水平为11.20±4.40,差异具有统计学意义(P<0.001)。NHL患者外周血Treg水平在男性患者中比在女性患者中高,差异具有统计学意义(P=0.030);在有吸烟和/或嗜酒组比在无吸烟和/或嗜酒组高,差异具有统计学意义(P=0.045);而NHL患者外周血Treg水平与年龄、分期、IPI评分、B症状、巨大包块、LDH水平、病理亚型、近期疗效、HBV感染等之间的相关检验无统计学意义。在弥漫大B细胞性淋巴瘤中分析结果亦相似。结论:初诊NHL患者体内存在免疫抑制,有吸烟和/或嗜酒等不良嗜好的NHL患者Treg水平较无不良嗜好者高,Treg水平与NHL的疾病状态无关。

Background and Objective. Non-Hodgkin＇s lymphoma （NHL） is a malignant disease originating from immune system. Studies of the possible relationship between NHL and immune suppression status are of great concern. Regulatory T cell （Treg） is a subtype of T cells that exert an immunosuppressive function. However, the relationship between Treg and lymphoma is controversial. The study was to detect peripheral blood levels of Treg in patients with NHL and healthy adults, and to explore the possible relationship between peripheral blood Treg level and NHL. Methods. By using flow cytometry with surface staining ftuorochrome-conjugated antibodies for CD4, CD25, CD127, the percentages of CD4＋CD25^highCD127^low Treg in peripheral blood of 31 healthy adults and 99 newly diagnosed NHL patients,hospitalized in Sun Yet-sen University Cancer Center from December 2006 to March 2008, were detected and analyzed. Results, The average peripheral blood CD4＋CD25^highCD127low Treg levels were 8.07 ±1.90 and 11.20±4.40 in healthy adults and newly diagnosed NHL patients, respectively. The difference of peripheral blood Treg levels between them was statistically significant （P〈 0.001,95% CI：2.02-4.23）. The peripheral blood level of Treg was significantly higher in the male NHL patients than in the female patients （P=0.030,95% CI： 0.19-3.77）. Patients with bad habits （smoking, addict to drink, or both） had significantly higher peripheral blood Treg level than patients without bad habits （P=0.045,95%CI：0.04-3.84）. It was no significant relation between peripheral blood Treg level and age, stage, IPI, B symptom, bulky disease, LDH level,pathologic subtype, short term response, HBV infection, and so on. The analysis in diffuse large B-cell lymphoma （DLBCL） subtype showed the same results. Conclusions. Newly diagnosed NHL patients are in an immunosuppressive statue. Patients with bad habits （smoking, addict to drink, or both） have higher peripheral blood Treg level. Peripheral blood Treg level is irrelevant to the status of disease.