外周血T细胞亚群在不同分期及Hans分型的弥漫大B细胞淋巴瘤的表达与意义

The Expression and Significance of Peripheral Blood T Lymphocyte Subsets in Diffuse Large B-cell Lymphoma with Different Stages and Hans Classification

目的探讨不同分期及Hans分型的弥漫大B细胞淋巴瘤(DLBCL)中外周血T细胞亚群的表达差异与意义。方法选择2019年9月-2021年2月南华大学衡阳医学院附属邵阳医院收治的56例DLBCL患者为观察组,同期34例体检中心的健康体检者为对照组。比较两组外周血T细胞亚群的水平,分析不同分期及Hans分型的DLBCL患者上述检测结果的差异。采用Logistic回归分析外周血T细胞亚群指标与DLBCL的关系。结果对照组的外周血T细胞亚群指标CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于观察组,CD8^(+)低于观察组,差异有统计学意义(P<0.05);观察组Ⅰ期、Ⅱ期、Ⅲ期及Ⅳ期CD3^(+)、CD4^(+)/CD8^(+)均低于对照组,CD8^(+)高于对照组,差异有统计学意义(P<0.05);Logistic回归模型分析显示,CD3^(+)、CD4^(+)水平降低,CD8^(+)水平升高均是DLBCL发生的独立危险因素。结论DLBCL外周血T细胞亚群的表达水平与其临床分期及Hans分型存在一定的关系,随着临床分期的增加或当疾病Hans分型分类为non-GCB型时,DLBCL患者免疫抑制较重。外周血T细胞亚群对临床分期及治疗具有一定的临床价值。

Objective To investigate the expression difference and significance of peripheral blood T cell subsets in patients with diffuse large B-cell lymphoma(DLBCL)with different stages and Hans classification.Methods A total of 56 patients with DLBCL treated in the Shaoyang Affiliated Hospital,Hengyang Medical School,University of South China from September 2019 to February 2021 were selected as the observation group,and 34 cases of health examination in physical examination center during the same period as control group.The levels of T cell subsets in peripheral blood were compared between the two groups,and the differences in the above test results of DLBCL patients with different stages and Hans types were analyzed.Logistic regression was used to analyze the relationship between peripheral blood T cell subsets and DLBCL.Results The peripheral blood T cell subsets CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the control group were higher than those in the observation group,and CD8^(+)was lower than that in the observation group,the difference was statistically significant(P<0.05).CD3^(+)and CD4^(+)/CD8^(+)in stage Ⅰ,Ⅱ,Ⅲ and Ⅳ of the observation group were lower than those of the control group,and CD8^(+)was higher than that of the control group,the difference was statistically significant(P<0.05).Logistic regression model analysis showed that the decrease of CD3^(+)and CD4^(+)levels and the increase of CD8^(+)levels were independent risk factors for DLBCL.Conclusion The expression of T cell subsets in peripheral blood of DLBCL is related to clinical stage and Hans classification.With the increase of clinical stage or when Hans classification is non-GCB type,the immunosuppression of DLBCL patients is severe.Peripheral blood T cell subsets have certain clinical value for clinical staging and treatment.