肿瘤相关巨噬细胞在慢性淋巴细胞白血病患者骨髓中的水平及意义

Expression and significance of tumor-associated macrophages in bone marrow of chronic lymphocytic leukemia

目的探讨慢性淋巴细胞白血病(CLL)患者骨髓中巨噬细胞的水平及在CLL发病中的作用。方法选取初诊CLL患者58例,其中Binet A期24例,Binet B期19例,Binet C期15例;20例缺铁性贫血患者作为对照组。采用免疫组织化学染色法检测CLL各组患者骨髓组织中巨噬细胞的标志物CD68+(M1+M2型)、CD163(M2型)的表达变化,比较其在不同分期CLL患者骨髓组织中的水平差异。结果 CLL各组患者骨髓组织中CD68+、CD163+细胞水平均明显高于对照组(P<0.05),而Binet C期患者高于Binet B期(P<0.05),Binet B期组高于Binet A期组(P<0.05);CLL病情进展与CD163+细胞浸润密度呈正相关(P<0.05)。结论巨噬细胞在CLL患者骨髓中具有较高的浸润密度,且在CLL不同时期浸润密度不同,随着病情的进展浸润到骨髓组织中的巨噬细胞逐渐向M2型极化,与CLL的病程进展具有相关性。

Objective To investigate the expression of macrophages in the bone marrow of chronic lymphocytic leukemia（CLL）patients and its clinical significance in the pathogenesis of CLL.Methods Fifty-eight patients with newly diagnosed CLL were selected,including 24 cases of Binet A,19 cases of Binet B,15 cases of Binet C,and 20 patients with iron deficiency anemia were selected as control group.Immunohistochemical staining was used to detect the expression of CD68＋（M1＋M2 type）and CD163（M2 type）in CLL patients.The expression differences in bone marrow tissues of CLL patients at different stages were compared.Results The numbers of CD68＋and CD163＋cells in CLL group were significantly higher than those in control group（P〈0.05）,while those in Binet C stage patients were higher than in Binet B stage patients（P〈0.05）and those in Binet B stage patients were higher than in Binet A stage patients（P〈0.05）.The progression of CLL was positively correlated with the infiltration density of CD163＋cells（P〈0.05）.ConclusionMacrophages have a high density of infiltration in the bone marrow of CLL patients,and the infiltration density varies in different periods of CLL.With the progresses of the disease,macrophages infiltrated into bone marrow gradually polarize to M2 type,which is relevant with the course of CLL progress.