滤泡辅助性T细胞和滤泡调节性T细胞在骨肉瘤患者中的数量变化及临床意义

Quantitative changes of follicular helper T cells and follicular regulatory T cells in osteosarcoma patients and their clinical significance

目的探讨滤泡辅助性T细胞(TFH)和滤泡调节性T细胞(TFR)在骨肉瘤患者外周血中的数量变化及与预后的关系。方法收集2015年1月至2018年12月20例骨肉瘤患者和20例健康体检者的静脉血,采用流式细胞术检测骨肉瘤患者和健康体检者外周血循环TFH细胞和TFR细胞频率,分析骨肉瘤患者不同年龄段、不同性别以及不同分期上述指标及TFH/TFR细胞频率比值。将外周血循环TFH/TFR细胞频率比值按中位值对骨肉瘤患者进行分层,并根据随访数据分析总生存期(OS)。结果流式细胞术检测结果显示,20例骨肉瘤患者外周血TFH细胞频率[(6.916±1.778)%vs.(2.310±0.874)%,P=0.004)]和TFR细胞频率[(3.016±0.760)%vs.(0.472±0.174)%,P=0.002)]均显著高于健康体检者。骨肉瘤患者TFH/TFR细胞频率比值为2.679±1.246,低于健康体检者的5.830±2.464(P=0.005)。10~25岁患者的外周血TFH细胞和TFR细胞频率明显高于其他年龄段(P<0.05),Ⅲ期患者外周血TFH细胞和TFR细胞频率明显高于Ⅰ期和Ⅱ期患者(P<0.05)。男性和女性骨肉瘤患者外周血TFH细胞和TFR细胞频率的差异无统计学意义(P>0.05)。以20例骨肉瘤患者外周血循环TFH/TFR细胞频率比值的中位数2.362为界值,分为低比值组(≤2.362)和高比值组(>2.362)各10例。20例骨肉瘤患者的中位OS为27个月。其中低比值组中位OS为19个月,低于高比值组的32个月,差异有统计学意义(P=0.036)。结论在骨肉瘤致病过程中,TFH细胞和TFR细胞频率显著升高,与年龄和分期有关。

Objective To investigate quantitative changes of follicular helper T cells(TFH)and follicular regulatory T cells(TFR)in patients with osteosarcoma,and the relationship of them with prognosis.Methods From January 2015 to December 2018,venous blood was collected from 20 osteosarcoma patients and 20 healthy controls.Flow cytometry was used to detect the frequency of TFH cells and TFR cells of osteosarcoma patients and healthy controls.The frequency ratio of TFH/TFR of patients with osteosarcoma was stratified according to the median value,and overall survival(OS)was analyzed according to the follow-up data.Results The results of flow cytometry showed that TFH cell frequency[(6.916±1.778)%vs.(2.310±0.874)%,P=0.004)]and TFR cell frequency[(3.016±0.760)%vs.(0.472±0.174)%,P=0.002)]of 20 patients were significantly higher than those of healthy controls.The TFH/TFR frequency ratio was 2.679±1.246,lower than 5.830±2.464 of healthy controls(P=0.005).The frequency of TFH cells and TFR cells increased significantly at the age of 10-25 years(P<0.05).In patients with osteosarcoma stage III,the frequency of them was significantly higher than that in patients of stage I and stage II(P<0.05).However,there was no significant difference in the frequency of TFH cells and TFR cells between male and female patients(P>0.05).The patients with osteosarcoma were divided into low ratio group(≤2.362)and high ratio group(>2.362)based on the median value of TFH/TFR frequency ratio.The median OS of 20 patients with osteosarcoma was 27 months.The median OS of patients with low ratio group was 19 months,shorter than 32 months of high ratio group(P=0.036).Conclusion In the pathogenesis of osteosarcoma,the frequency of TFH cells and TFR cells increases significantly,and it is related to age and stage.