B-ALL患者外周血T细胞表面CD28和CTLA-4表达的初步研究

Preliminary research of expression CD28 and CTLA-4 on peripheral T cell surface in children with acute lymphoblastic leukemia of type B before chemotherapy

目的:探讨B型急性淋巴细胞白血病(B-ALL)患儿外周血IL-2及T淋巴细胞表面CD28、CTLA-4的表达及其临床意义。方法:利用流式细胞(FCM)技术和放射免疫分析法检测41例初发B-ALL患儿外周血T细胞表面CD28、CTLA-4以及血清IL-2的表达,39例正常儿童作为对照,分析其与白血病发病的关系。结果:B-ALL患儿外周血CD4+、CD8+T淋巴细胞CD28表达为(22.79±2.20)%和(4.84±0.32)%,明显低于正常对照组(37.13±1.92)%和(13.24±0.84)%,t值分别为32.67和67.62,P值均<0.05;而CD4+、CD8+T淋巴细胞CTLA-4表达(11.39±0.89;12.32±0.43)明显升高(2.35±0.29;0.73±0.20),t值分别为61.20和154.97,P值均<0.05;血清IL-2的表达明显降低(19.17±8.94 vs 53.61±9.36),P<0.01。结论:B-ALL患儿T淋巴细胞免疫活化能力降低,Th1型细胞因子处于劣势,机体处于免疫抑制状态,抗肿瘤能力降低。

OBJECTIVE：To investigate the expressions of interleukin-2 and the costimulatory molecules CD28 and CTLA-4 in peripheral blood lymphocytes with B-Acute lymphoblastic leukemia（B-ALL）. METHODS： CD28 and CTLA-4 in 41 patients with newly diagnosed B-ALL and 39 control cases were measured by flow cytometry （FCM）,and IL-2 was detected by MTT biochemical methods. RESULTS： CD28 in B-ALL group [（22.79±2.20） % ; （4.84±0.32） %3 was sig- nificantly lower than CD28 in control group [（37.13±1.92） %, （13.24±0.84）% ; t were 32.67 and 67.62 respectively, P〈 0.05] ; CTLA-4 in B-ALL （11. 39 ± 0. 89; 12. 32 ± 0. 43） was significantly higher than CTLA-4 in controls group （2.35±0. 29,0.73±0. 20; t were 61.20 and 154. 97 respectively,P〈0.05） ; compared with healthy controls,the IL-2 level decreased significantly（ 19.17± 8.94 vs 53.61 ± 9.36, P〈0.01）. CONCLUSIONS： B-ALL patients have a significant- ly lower cellular immune activation and anticancer ability than those in normal control. Thl type cytokines is in disadvan- tage and the patients is in immunosuppressive state.