外周血CD4+T对滤泡性淋巴瘤的检测价值研究

Detection Value of Peripheral Blood CD4+T in Follicular Lymphoma

目的探讨外周血CD4+T对滤泡性淋巴瘤的检测价值。方法选取鹤煤总医院2011年2月-2012年6月收治的68例滤泡性淋巴瘤(FL)患者作为研究对象。对疗效进行评估;采集外周静脉血标本,检测所有患者全血细胞,包括淋巴细胞绝对数(ALC)、单核细胞绝对数(AMC)、血小板(Plt)和CD4+T淋巴细胞绝对数(ACD4C);随访5年。结果治疗6个疗程后,68例滤泡性淋巴瘤患者中,完全缓解(CR)40例、未证实的完全缓解(uCR)7例、部分缓解(PR)9例,总有效率为82.35%,疾病稳定(SD)7例,疾病进展(PD)5例,无效率为17.65%。FLIPI评分系统低危、中危、高危有效率比较差异无统计学意义(P>0.05),而不同ACD4C分组中有效率差异有统计学意义(P<0.05)。滤泡性淋巴瘤患者平均无进展生存时间(PFS)和总生存时间(OS)分别为78个月和126个月。3年和5年PFS比例分别为73.53%(50/68)和60.29%(41/68),3年和5年OS比例分别为82.35%(56/68)和73.53%(50/68)。多因素COX回归分析显示ACD4C<1.5×10^8/L是影响滤泡性淋巴瘤预后的独立因素(P<0.05)。结论外周血低CD4细胞数目与滤泡性淋巴瘤患者疗效较差和预后不良相关,可作为滤泡性淋巴疗效和预后评估的有效指标。

Objective To investigate the value of CD4+T in peripheral blood of follicular lymphoma.Methods 68 patients with follicular lymphoma treated from February,2011 to June,2012 were enrolled in the study.Absolute lymphocytes counting(ALC),absolute monocytes counting(AMC),platelet(Plt)and absolute number of CD4+T lymphocytes(ACD4 C)were measured in all patients with peripheral blood samples.Follow up were made for 5 years.Results After treatment for 6 courses,among 68 follicular lymphoma patients,40 cases were of complete remission(CR),7 cases were unconfirmed complete remission(uCR),and 9 cases were partial remission(PR).The total effective rate was 82.35%.7 cases were of stable disease(SD),5 cases were of progression of disease(PD),and the non-efficiency was 17.65%.There was no significant difference in the low risk,middle risk and high risk of FLIPI scoring system(P>0.05).There was significant difference in the efficiency of different ACD4 C groups(P<0.05).The mean PFS and OS in patients with follicular lymphoma were 78 months and 126 months,respectively.The proportion of PFS was 73.53%(50/68)and 60.99%(41/68)in 3 years and 5 years respectively,and the OS ratio was 82.35%(56/68)and 73.53%(50/68)respectively.Multivariate COX regression analysis showed that ACD4 C<1.5×10^8/L was an independent factor influencing the prognosis of follicular lymphoma(P<0.05).Conclusion The number of CD4 cells in peripheral blood is related to the poor curative effect and poor prognosis of follicular lymphoid patients,and can be used as an effective index for the evaluation of follicular lymphoid effect and prognosis.