T淋巴细胞亚群检测在华氏巨球蛋白血症中的临床意义

Clinical Significance of T Lymphocyte Subsets in Patients with Waldenstrom Macroglobulinemia

目的:探讨外周血T淋巴细胞亚群检测在华氏巨球蛋白血症(WM)患者中的临床意义。方法:选取44例初诊WM患者为WM组,以同期健康体检的20例正常人为健康对照组,检测外周血T细胞亚群,随访统计WM患者总体生存期(OS)和无进展生存期(PFS)。结果:WM患者CD^(4+)细胞比例及CD^(4+)/CD^(8+)比值低于健康对照组,差异均具有统计学意义(P<0.05)。男性、伴有遗传学异常的WM患者CD^(3+)细胞比例分别低于女性及遗传学正常患者,差异均有统计学意义(P<0.05);<65岁、ISSWMⅠ期、Ca^(2+)正常患者CD^(4+)/CD^(8+)比值分别高于≥65岁、ISSWMⅡ、Ⅲ期、低Ca^(2+)患者,差异均有统计学意义(P<0.05);低Ca^(2+)、细胞遗传学异常患者CD^(8+)细胞分别高于Ca^(2+)正常、遗传学正常患者,差异均具有统计学意义(P<0.05)。高CD^(3+)、CD^(4+)组患者OS优于低CD^(3+)、CD^(4+)患者,差异均具有统计学意义(P<0.05)。CD^(4+)/CD^(8+)≥1.5患者OS及PFS优于CD^(4+)/CD^(8+)<1.5患者,差异均有统计学意义(P<0.05)。结论:对初诊WM患者进行外周血T细胞亚群检测,有助于了解患者的免疫功能,CD^(3+)、CD^(4+)细胞及CD^(4+)/CD^(8+)比值降低提示预后不良。

Objective:To explore the clinical significance of circulating T-lymphocyte subsets detection in Waldenstrom Macroglobulinemia(WM)patients.Methods:A total of 44 newly diagnosed WM patients and 20 healthy controls were selected.Peripheral blood T cell subsets were detected,and the overall survival(OS)and progress-free survival(PFS)of WM patients were calculated.Results:The proportion of CD^(4+)and CD^(4+)/CD^(8+)ratio in WM patients were significantly lower than those in healthy controls(P<0.05).Male patients and patients with cytogenetic abnormities had lower level of CD^(3+)cells than the counter parts(P<0.05).Age less than 65 years,ISSWM I stage and normal level of Ca^(2+)were associated with a higher CD^(4+)/CD^(8+)ratio(P<0.05).CD^(8+)level in patients with low Ca^(2+),abnormal cytogenetics were higher than those in patients with normal Ca^(2+)and normal genetics,respectively(P<0.05).The univariate survival analysis showed that low level of CD^(3+),CD^(4+)and CD^(4+)/CD^(8+)ratio inversion(CD^(4+)/CD^(8+)<1.5)were significantly associated with shorter OS and PFS(P<0.05).Conclusions:T cell subsets in peripheral blood of newly diagnosed WM patients is associated with the immune function of the patients.Reduction of CD^(3+),CD^(4+)cells and CD^(4+)/CD^(8+)ratio suggest poor prognosis of WM patients.