老年急性髓细胞白血病患者调节性T细胞的表达及临床意义

The expression features and clinical significance of CD4^＋ CD25^＋ regulatory T cells in elderly patients withacute myelocytic leukemia

目的探讨老年初诊急性髓细胞白血病患者体内CD4^＋CD25＋凋节性T细胞（CD4＋CD25^＋Treg）的表达特点和临床意义。方法以65例初诊AML患者和72例健康志愿者（对照组）为研究对象，每组再按照年龄（≥60岁）分为老年组和中青年组，采用CD4、CD25和CDl27三色荧光素标记及流式细胞术检测CD4^＋CD25^＋Treg细胞，进而分析CD4^＋CD25^＋CDl27^low细胞在各组中的表达特点和临床意义。结果以CD4^＋T细胞设门，CD4^＋CD25^＋CDl27^lowT细胞AML组明显高于对照组，分别为（7．06±2．60）％比（5．61±1．06）％（t=4．19，P=0．000）；老年AML组显著高于老年对照组[（7．55±2．78）％比（5．98±1．08）％，t=3．42，P=0．001]，中青年AML组高于中青年对照组[（6．09±1．D1）％比（5．14±0．82）％，t=2．21，P=0．086），老年AML组高于中青年AML组[（7.55±2．78）％比（6．09±1．91）％，t=2．19，P=0．0322。结论免疫衰老及肿瘤的双重作用导致了老年初诊AML患者体内CD4^＋CD25^＋Treg细胞过度累积。

Objective To investigate the expression features and clinical significance of CD4^＋ CD25^＋ regulatory T cells in elderly patients with newly diagnosed acute myelocytic leukemia. Methods Totally 65 patients newly diagnosed as acute myeloid leukemia （AML group） and 72 healthy volunteers （control group） were divided into the elderly group （aged over 60 years） and the young group aged （44.6±2.9）years. The expression of CD4^＋ CD25^＋ regulatory T cells was detected by CD4, CD25 and CD127 three-color fluorescein labeled and multiparameter flow eytometry. The expression features and clinical significance of CD4^＋ CD25^＋ regulatory T cells in each group were analyzed. Results After being gated on CD4^＋ lymphoeytes, the expression level of CD4^＋ CD25^＋ regulatory T cells was significantly increased in AMI. group as compared to control group [（7.06±2.60） %. （5.61±1.06） %, t = 4.19, P= 0. 000]. The expression level of CD4^＋ CD25^＋ regulatory T cells was higher in elderly AML patients than in elderly controls [（7.55 ± 2.78）% vs（5.98 ± 1.08）%, t= 3.42, P=0. 001]. The expression of CD4^＋ CD25^＋ regulatory T cells was higher in young AMI. patients than in young controls 〈（6.09±1.91）% vs. （5.14±0.82）%,t=2.21, P=0. 0361. The expression level of CD4^＋ CD25^＋ regulatory T cells was higher in elderly AML patients than in young AML patients [（7.55±2.78）% vs. （6.09±1.91）%,t=2.19,P=0.032]. Conclusions The dual roles of immunosenescence and tumor may cause the excessive accumulation of CD4^＋ CD25^＋ regulatory T cells in elderly patients with newly diagnosed acute myeloid leukemia.