慢性髓细胞白血病患者Th1及CD8^+T淋巴细胞水平与疗效的相关性分析

The investigation on the correlation of the Th1 and CD8^+T lymphocyte levels with clinical efficacy in patients with chronic myeloid leukemia

目的分析慢性髓细胞白血病(CML)患者辅助性T淋巴细胞1(Th1)及CD8^+T淋巴细胞水平与临床疗效的关系。方法选取2018年2-12月于四川省人民医院确诊为CML的患者,采用流式细胞学技术检测患者外周血Th1比例(Th1/CD4^+T)及CD8^+T淋巴细胞比例(CD8^+T/Lymphocyte),并评估检测时相应缓解状态,进一步分组比较。结果初诊组(n=10)Th1低于正常下限的患者所占比例高于细胞遗传学完全缓解(CCyR)组(n=13)及分子学缓解4.5(MR4.5)组(n=67),差异均有统计学意义(P=0.01、0.00);初诊组Th1/CD4^+T亦低于CCyR组及MR4.5组,差异均有统计学意义(P=0.01、0.00)。进一步统计分析显示:Th1高CD8^+T高组患者(n=15)MR4.5率高于Th1高CD8^+T非高组(n=17),差异有统计学意义(P=0.03);而两组未缓解率比较,差异无统计学意义(P=0.74)。Th1高CD8^+T高组患者MR4.5率高于Th1低CD8^+T高组(n=10),未缓解率低于Th1低CD8^+T高组(均P=0.00)。结论治疗后良好的疗效表现为较初诊时显著升高的Th1水平,Th1/CD4^+T及CD8^+T/Lymphocyte均高于正常上限者显示出更高的缓解率与更深的缓解度。

Objective To investigate the correlations of levels of helper T lymphocyte 1(Th1)and CD8^+T lymphocytes with clinical efficacy in patients with chronic myeloid leukemia(CML).Methods Patients diagnosed with CML in Sichuan Provincial People′s Hospital from February to December 2018 were selected.The Th1 proportion(Th1/CD4^+T)and CD8^+T lymphocyte proportion(CD8^+T/Lymphocyte)in peripheral blood were detected by Flow cytometry,and the corresponding remission status at the time of detection were evaluated.The data were statistically analyzed in different groups.Results The Th1 level in 70.00%of the patients in newly-diagnosed group(n=10),15.38%of the patients in complete cytogenetic response(CCyR)group(n=13)and 15.15%of the patients in molecular response 4.5(MR4.5)group(n=67)were below the lower limit of normal.The low-Th1 percentage of the newly-diagnosed group was significantly higher than that of the CCyR group and that of the MR4.5 group,and there were statistically significant differences(P=0.01,0.00).Additionally,the value of Th1/CD4^+T in the newly-diagnosed group was also significantly lower than that in the CCyR group and that in the MR4.5 group,and there were statistically significant differences(P=0.01,0.00).The MR4.5 rate in the high-Th1 and high-CD8^+T group(n=15)was significantly higher than that in the high-Th1 and not-high-CD8^+T group(n=17),and there was statistically significant difference(P=0.03),while no statistically significant difference was found in the un-remission rate between the two groups(P=0.74).The MR4.5 rate in the high-Th1 and high-CD8^+T group was also significantly higher than that in the low-Th1 and high-CD8^+T group(n=10),while the un-remission rate in the high-Th1 and high-CD8^+T group was significantly lower than that in the low-Th1 and high-CD8^+T group(P=0.00,0.00).Conclusion The good therapeutic efficacy of patients with CML after treatment shows a significantly higher Th1 level compared with the level of patients at newly diagnosis.And those patients whose Th1 level and CD8^+T level are both higher than the upper limit of normal show the higher remission rate and the deeper remission level.