多发性骨髓瘤患者外周T淋巴细胞亚群和NK细胞比值与预后关系

The Relationship Between Peripheral T Lymphocyte Subsets and NK Cell Ratio and Prognosis in Patients with Multiple Myeloma

目的探讨多发性骨髓瘤患者外周T淋巴细胞亚群和NK细胞比值与预后的关系。方法采用流式细胞术检测123例初治骨髓瘤患者化疗前及化疗中和全疗程结束后外周血T淋巴细胞亚群与NK细胞的表达水平。比较各期患者治疗前后与健康对照组外周T淋巴细胞亚群和NK细胞水平。结果Ⅰ期多发性骨髓瘤患者的CD3^+、CD4^+、CD4^+/CD8^+比值下降,CD8^+升高,与对照组相比较,差异有统计学意义(P<0. 05)。CD56^+在Ⅰ期及Ⅲ期表达增高,Ⅱ期表达下降,差异有统计学意义(P <0. 05)。治疗后CD4^+T细胞、CD4^+/CD8^+及CD56^+NK细胞的百分比与治疗前相比较明显上升,而CD8^+T细胞的百分比与治疗前相比较明显下降,差异有统计学意义(P <0.05)。结论外周T淋巴细胞亚群和NK细胞的检测可用于不同时期的多发性骨髓瘤的诊断及预后预测,具有重要的临床应用价值。

Objective To investigate the relationship between peripheral T lymphocyte subgroup and NK cell ratio and prognosis in patients with multiple myeloma. Methods The expression of T lymphocyte subsets and NK cells in peripheral blood of 123 patients with newly diagnosed myeloma before,during and after chemotherapy were detected by flow cytometry.The peripheral T lymphocyte subsets and NK cell levels were compared with those in the healthy control group before and after the treatment. Results Compared with the control group,the early stage of MM patients had CD3^+,CD4^+,CD4^+/CD8^+ decreased significantly,and CD8 increased( P <0.05).After the treatment,the percentage of CD4^+ T cells,CD4^+/CD8^+ and CD56^+ NK cells increased significantly compared with that of before treatment,while the percentage of CD8^+ T cells decreased significantly compared with that of before treatment( P <0.05). Conclusion The detection of T lymphocyte subsets in peripheral blood and immunophenotype analysis of bone marrow cells in patients with MM by flow cytometry can improve the diagnosis and prognosis of the disease.