慢性淋巴细胞白血病患者血清TGF-β、IL-17、IL-4及IFN-γ水平变化及其临床意义

The level and its clinical significance of TGF-β,IL-17,IL-4 and IFN-γ in serum of patients with chronic lymphocytic leukemia

目的探讨慢性淋巴细胞白血病(CLL)患者血清转化生长因子-β(TGF-β)、白介素-17(IL-17)、白介素-4(IL-4)及干扰素-γ(IFN-γ)水平变化及其临床意义。方法选取确诊为CLL患者60例为初诊CLL组,20例健康人作为对照组,并对32例患者进行了治疗随访(治疗后组),用ELISA技术检测血清IL-17、TGF-β、IL-4和IFN-γ及其比值的变化。结果初诊CLL组患者外周血IL-17、TGF-β、IL-4、TGF-β/IL-17比值均高于对照组(P<0.05),IFN-γ及IFN-γ/IL-4比值均低于对照组(P<0.05),治疗后组TGF-β、IL-17、IL-4及TGF-β/IL-17均低于初诊CLL组(P<0.05),IFN-γ及IFN-γ/IL-4高于初诊CLL组(P<0.05)。在Binet A期、B期、C期分期中,TGF-β/IL-17比值逐渐增高,其中C期高于A期和B期(P<0.05),IFN-γ/IL-4比值逐渐减低(P<0.05),初诊CLL组患者TGF-β/IL-17及IFN-γ/IL-4比值与Binet分期均呈正相关。结论随着疾病的进展,CLL患者细胞因子IFN-γ/IL-4和TGF-β/IL-17的格局发生变化,TGF-β/IL-17比值逐渐增高,IFN-γ/IL-4比值逐渐减低,IFN-γ/IL-4和TGF-β/IL-17的比值可能可以作为CLL患者疾病进展及预后评价指标之一。

Objective To investigate the clinical significance of TGF-β,IL-17,IL-4 and IFN-γ level in serum of patients with chronic lymphocytic leukemia（ CLL）. Methods The study enrolled 20 healthy individuals and 60 CLL patients. 32 patients were received treatment and followed-up. ELISA was used to measure the level of transformation growth factor-β（ TGF-β）,interleukin-17（ IL-17）,interleukin-4（ TGF-β,IL-4）,interferon-γ（ IFN-γ）in the serum of the every group. Results（ 1） The level of IL-17,TGF-β,IL-4 and the ratio of TGF-β / IL-17 in peripheral blood of first visit CLL patients group were higher than those in the control group（ P〈0. 05）. The level of IFN-γ and the ratio of IFN-γ / IL-4 were lower than those in the control group（ P〈0. 05）. Compared with the CLL group,the treated cases had the lower level of TGF-β,IL-17,IL-4 and TGF-β / IL-17（ P〈0. 05）. The ratio of IFN-γ and IFN-γ / IL-4 in treated cases was higher（ P〈0. 05） than that in the CLL group.（ 2） In stage of Binet A,B,C,the later stage the higher ratio of TGF-β / IL-17 and the ratio of TGF-β / IL-17 in stage Binet C was higher than that in stage Binet A and Binet B（ P〈0. 05）. In the later the stage,the the ratio of IFN-γ / IL-4 decreased gradually（ P〈0. 05）. The ratio of IFN-γ and IFN-γ / IL-4 were positively correlated with the clinical Binet stages in first visit CLL group. Conclusion With the progression of disease,the ratio of TGF-β / IL-17 and IFN-γ / IL-4were changed in CLL patients.,With the progression of the disease,the ratio of TGF-β / IL-17 increased gradually,and the ratio of IFN-γ / IL-4 decreased gradually. The ratio of TGF-β / IL-17 and IFN-γ / IL-4 might be one of the evaluation index for disease progression and prognosis of in patients with CLL.