弥漫大B细胞淋巴瘤细胞免疫状态与国际预后指数的关系

Relationship between the international prognosis indexes and the cell-mediated immunity condition in DLBCL patients

目的探讨弥漫大B细胞淋巴瘤（DLBCL）患者细胞免疫状态与国际预后指数（IPI）的关系。方法初治DLBCL患者52例，按照IPI积分分为4组（低危组17例、低中危组16例、中高危组12例、高危组7例），采用流式细胞术检测各DLBCL组与健康对照组（43例）T淋巴细胞亚群（包括CD3、CD3C4、CD3CD8）、NK细胞的绝对计数值及CD；／CD]，各组间比较并分析IPI的5个指标与各T淋巴细胞亚群绝对值的相关陆。结果DLBCL高危组的CD3细胞（1570．9±370．5）个／μl，较其他IPI组高；DLBCL4组的CD4细胞数均低于健康对照组的（751．3±367．4）个／μl；DLBCL高危组的cD；细胞（1055．9±523．8）个／μl，较健康对照组及其他IPl分组明显升高；中高危组与高危组的CD]／CD；LL值（1．0±0．2、0．7±1．0）降低明显，与健康对照组、低危组、低中危组比较差异均有统计学意义（P〈0．05）；中高危组与高危组NK细胞较健康对照组明显降低[（199.5±68．4）／m、（171．9±126．9）／μl]。淋巴瘤患者的年龄、临床分期、全身状态与患者外周血T淋巴细胞亚群中的CD；细胞数、CD8细胞数以及CD4／CD8 比值有相关性。结论初治的DLBCL患者细胞免疫状态与1PI有关；随着IPI积分的增加，DLBCL患者免疫抑制与紊乱加重，NK细胞功能越差，预后也更差。

Objective To explore the relationship between the international prognosis indexes（IPI） and the cell-mediated immunity condition in DLBCL patients. Methods 52 DLBCL patients were divided into 4 groups and the FCM was used to examine the T lymphocyte subsets, including CD3,CD4,CD8 NK cells . T lymphocyte subsets absolute value and CD4/CD8 ratio were examined. Correlation with IPI were compared among groups. Results CD; cells in high risk group [（1570.9±370.5）/μl]were higher than other IPI groups; CD4 cells in DLBCL groups were all lower than normal group（751.3±367.4）/μl]; CD8 cells in high risk group [（ 1055.9±523.8）/μ1] were higher than other groups; CD4/CD8 ratio in middle-high risk group and high risk group （1.0±0.2,0.7±1.0） were lower than other IPI groups and normal group; NK cells in middle-high risk group and high risk group were lower than the normal group [（199.5±68.4）/μl,（171.9±126.9）/μl]; Age, clinical stage,body state had correlated with the CD3 ,CD4 cells and CD4/CD8 ratio of the DLBCL patients＇ peripheral blood T lymphosyte subsets. Conclusions The immunity condition in DLBCL patients has correlated with IPI; With increasing IPI value, the immunity depression and disorder become more serious, NK cells function become worse, and the prognosis is bad too.