T淋巴细胞亚群与NK细胞检测在弥漫大B细胞淋巴瘤患者治疗中的意义探讨

Significance of T lymphocyte subsets and NK cells in the treatment of diffuse large B-cell lymphoma patients

目的探讨T淋巴细胞亚群和NK细胞检测在弥漫大B细胞淋巴瘤(DLBCL)患者治疗中的应用价值。方法选取四川大学华西广安医院2015年3月至2017年6月收治的66例DLBCL患者和同期在我院进行健康检查的45例健康人(对照组)进行研究,DLBCL患者中36例治疗后为完全缓解(CR组),30例为部分缓解(PR组);采用流式细胞仪测定患者化疗前后静脉血肿T淋巴细胞亚群和NK细胞水平变化。结果化疗前,CR组和PR组患者CD3^+、CD4^+、CD4^+/CD8^+以及NK细胞活性水平均低于对照组,CD8^+水平高于对照组(P<0.05);CR组患者化疗2周和化疗4周后CD3^+、CD4^+、CD4^+/CD8^+及NK细胞水平均升高(P<0.05);PR组患者化疗前与化疗2、4周后的T淋巴细胞亚群和NK细胞水平比较差异无统计学意义(P>0.05)。结论 DLBCL患者存在免疫抑制情况,患者治疗前后体内T淋巴细胞亚群和NK细胞水平变化明显,可用于临床上评估DLBCL患者的临床治疗效果。

Objective To evaluate the application value of T lymphocyte subsets and NK cells in the treatment of patients with diffuse large B cell lymphoma（ DLBCL）. Methods A total of 66 patients with DLBCL who were treated in Guangan hospital from March 2015 to June 2017 were enrolled in this study.At the same,45 healthy subjects who had health examination in our hospital were also involved in the study as a control group.Of the 66 patients with DLBCL,36 were complete remission（ CR group） while remained 30 were partial remission（ PR group）.Flow cytometry was used to measure the changes of T lymphocyte subsets and NK cells in venous hematoma before and after chemotherapy.Results Before chemotherapy,the levels of CD3^＋,CD4^＋,CD4^＋/CD8^＋and NK cells in the DLBCL group were significantly lower while the levels of CD8^＋were significantly higher than those in the control group（ P〈0. 05）.After 2 and 4 weeks of chemotherapy,the levels of CD3^＋,CD4^＋,CD4^＋/CD8^＋and NK cells in the CR group were significantly increased when compared to before chemotherapy（ P〈0. 05）.There was no significant difference in the levels of T lymphocyte subsets and NK cells before and after 2 and 4 weeks of chemotherapy（ P〉0. 05）. Conclusion There is immunosuppression in DLBCL patients. The levels of T lymphocyte subsets and NK cell are significantly changed before and after treatment.Therefore,detection of the changes can be used for evaluation of clinical treatment efficiency in patients with DLBCL.