摘要
目的 探讨多发性骨髓瘤(MM)患者细胞免疫功能变化及其临床意义.方法 45例MM患者分为初诊组(18例)、治疗后病情稳定期组(17例)和复发/难治组(10例),以20名健康志愿者为正常对照组.采用流式细胞术检测外周血T细胞亚群、NK细胞、树突细胞(DC)、辅助性T细胞(Th1和Th2)、调节性T细胞(Treg)和Th17细胞在CD4+细胞中所占比率.结合患者血清β2微球蛋白(β2-MG)、LDH和HGB水平进行分析.结果 ①初诊组患者Treg、NK细胞比率及CD4+/CD8+细胞、DC1/DC2、Th1/Th2比值较正常对照组和病情稳定期组均降低,IL-17A/Treg比值显著升高(P值均<0.05);与病情稳定期组相比,复发/难治组患者CD4+/CD8+细胞、Th1/Th2比值显著下降,IL-17A/Treg比值显著升高(P值均<0.05).②随着临床ISS分期增高,CD4+/CD8+细胞、Th 1/Th2比值明显降低,IL-17A/Treg比值明显升高(P值均<0.05).③MM患者CD4+/CD8+细胞、Th 1/Th2、DC 1/DC2比值与血清β2-MG和LDH的表达水平呈显著负相关(P值均<0.05);IL-17A/Treg比值与两者呈显著正相关(P值均<0.05);各项免疫指标与HGB水平无明显相关性(P值均>0.05).结论 CD4+/CD8+细胞、Th 1/Th2、DC1/DC2以及IL-17A/Treg比值的异常与MM患者的病情分期、疗效、发展以及预后密切相关.
Objective To investigate cellular immune function and its clinical significance in patients with multiple myeloma (MM).Methods 45 MM patients were divided into three groups:newly diagnosed (n=18),stable stage (n=17) and relapsed/refractory (n=10).The frequencies of T cell subtypes,natural killer (NK) cells,dendritic cells (DC),helper T cells (including Th1 and Th2),regulatory T cells (Treg) and Th17 cells in peripheral blood were detected by flow cytometry.Serum concentrations of β2 microglobulin (β2-MG),lactate dehydrogenase (LDH) and hemoglobin (Hb) were also detected,respectively.Results Compared with controls and stable stage group,the ratios of CD4+/CD8+,DC1/DC2,and Th1/Th2,the numbers of Treg and NK cells were significantly lower in newly diagnosed group.However,the ratio of IL-17A/Treg was significantly higher in newly diagnosed group (P〈0.05).Compared with stable stage group,the ratios of CD4+/CD8+,DC 1/DC2 and Th 1/Th2 were significantly lower,and the ratio of IL-17A/Treg was significantly higher in relapsed/refractory group (P〈0.05).In higher ISS stages,the ratios of CD4+/CD8+ and Th1/Th2 were significantly lower and the ratio of IL-17A/Treg was significantly higher (P〈0.05).There were negative correlations between the ratios of CD4 +/CD8 +,DC1/DC2,Th1/Th2 and the levels of β2-MG and LDH,respectively (P〈0.05).The ratio of IL-17A/Treg was positively correlated with the levels of β2-MG and LDH (P〈0.05).They were no correlated with the level of Hb (P〉0.05).Conclusion The abnormal ratios of CD4+/CD8+,DC1/DC2,Th1/Th2 and IL-17A/Treg were closely related with disease condition stages,treatment outcomes,progression and prognosis in MM patients.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2014年第12期1053-1057,共5页
Chinese Journal of Hematology
基金
教育部博士点基金(20130001110090、20120001120132)
首都健康培育项目(z111107067311050)