初发弥漫大B细胞淋巴瘤外周血Treg绝对数减少与不良预后的相关性

The Relationship between Reducing of Peripheral Blood Treg in Primary Diffuse Large B-Cell Lymphoma Patients and Poor Prognosis

目的:探索初发弥漫大B细胞淋巴瘤(DLBCL)患者外周血Treg细胞水平与预后的相关性。方法:采用流式细胞术检测初发DLBCL患者外周血Treg百分比及绝对数,通过生存分析明确其与预后的相关性。运用最大选择Log-rank检验,找到Treg绝对数作为连续变量用于区分不同预后结果的界值。将Treg绝对数依界值的新分组与年龄、性别、病理亚型、危险度分层、治疗方案等指标一同纳入Kaplan-Meier单因素生存分析,最终使用COX比例风险模型验证上述指标对预后的影响。结果:初发DLBCL患者外周血Treg绝对数在疾病难治复发组较完全缓解组明显降低。Treg绝对数界值为19个/μl。外周血Treg绝对数减低为独立于危险度分层的不良预后因素。结论:初发DLBCL患者外周血Treg绝对数减低提示预后不良。

Objective:To explore the relationship between Treg cells level in peripheral blood and prognosis of patients with diffuse large B-cell lymphoma(DLBCL).Methods:The percentage and absolute value of Treg cells in peripheral blood of DLBCL patients were detected by flow lytometry,and their correlation to prognosis was analyzed by survival analysis.The absolute count of Treg cells was detected by using maximally selected Log-rank statistic,and it was used as cutoff point to distinguish difference survival.The new group of Treg based on cutoff point was combined with age,sex,pathological subtype,risk stratification,treatment plan,and other indicators to include in the single factor survival analysis of Kaplan-Meier.Finally,the COX proportional risk model was used to verify the effect of the above indicators on progression-free survival.Results:The absolute count of Treg cells in DLBCL patients was significantly lower in the disease progressed group than those in the remission group.The cutoff point of absolute value of the Treg cell was 19 cells/μ 1.The absolute count of Treg cells was an independent prognostic factor of the risk stratification.Conclusion:At the beginning of diagnosis,the reduction of the absolute count of Treg cells in peripheral blood of DLBCL patients show a poor prognosis.