MM病人外周血NK细胞数量和活性变化及其意义

CHANGES OF NK CELL NUMBER AND ACTIVITY IN PERIPHERAL BLOOD IN PATIENTS WITH MULTIPLE MYELOMA

目的探讨外周血中自然杀伤(NK)细胞数量和活性的变化在多发性骨髓瘤(MM)的诊断、分期、治疗及预后判断中的作用,寻求新的免疫学治疗方法。方法采用流式细胞术检测60例MM病人(初发组、缓解组各30例)及30例健康对照组NK细胞的数量,应用CCK-8法测定各组NK细胞的活性。结果 MM初发组病人NK细胞数量和活性较对照组均明显下降(F=84.864、103.899,q=12.066、14.382,P<0.01);缓解组病人NK细胞数量与对照组比较无明显变化(P>0.05),但活性较对照组明显下降(q=6.342,P<0.01);缓解组病人NK细胞数量和活性均较初发组明显升高(q=10.288、8.040,P<0.01)。MM初发组血清清蛋白、β2-微球蛋白、肌酐和血钙水平与缓解组和对照组比较差异均有显著性(F=19.086～76.780,q=4.768～11.178,P<0.01);缓解组清蛋白、β2-微球蛋白水平与对照组比较差异有显著性(q=6.410、2.983,P<0.01),但肌酐和血钙水平与对照组比较差异无统计学意义(P>0.05)。结论检测NK细胞数量和活性的变化对MM的诊断、分期及预后判断都具有重要意义。

Objective To explore the role of changes of activity and quantity of natural killer （NK） cells in peripheral blood in the diagnosis, staging, therapy and predicting prognosis of multiple myeloma （MM） and seek a new immunotherapy. Methods Flow cytometry was used to detect the quantity of NK cells in 60 MM patients （30 in initial and 30 in remission group） and 30 healthy controls, and CCK 8 assay for the activity of NK cells. Results The number and activity of NK cells in the initial MM declined as compared with the control （F = 84.864,103.899 ;q=12.066,14.382;P〉0.01） ; the difference of changes in number of NK cells between patients in remission group and those in the control group was not significant, hut the activity was lowered in the MM （q=6.342,P〈0.01） ; the quantity and activity of NK ceils in patients of remission group were higher than that in the ini tim group （q = 10.288,8.040 ; P〈0.01 ）. The differences of serum albumin, β2-microglobulin, ereatinine and serum calcium levels between the initial group and the control were significant （F =19.086 -- 76. 780 ; q = 4.768 -- 11.178 ; P 〈0.01 ）, that of albumin and β2-microglobulin between the remission and the control were significant （q = 6.410,2.983;P 〈0.01）, but that of creatinine and ser um calcium were not （P〉0.05）. Conclusion A detection of quantity and activity of NK cells is of great significance in the diag nosis, staging, and prediction of prognosis of multiple myeloma.