急性髓系白血病患者外周血T淋巴细胞亚群表达水平及其与临床病理特征的关系

Expression level of T lymphocyte subsets in peripheral blood of patients with acute myeloid leukemia and its relationship with clinicopathological features

目的分析急性髓系白血病(AML)患者外周血T淋巴细胞亚群表达水平及其与临床病理特征的关系。方法回顾性选取2019年3月至2021年3月于该院就诊的85例AML患者作为AML组,进一步根据AML患者染色体检查情况将其分为高危组(25例)和非高危组(60例),另取85例同期体检健康者作为体检健康组。所有AML患者入组后均接受标准诱导方案治疗,根据临床疗效可将其分为完全缓解(CR)组(55例)和未CR组(30例)。检测并比较AML组与体检健康组、高危组与非高危组、CR组及未CR组的外周血T淋巴细胞亚群表达水平,同时分析AML患者外周血T淋巴细胞亚群表达水平与临床病理特征的关系。结果AML组外周血CD3^(+)、CD4^(+)T淋巴细胞比例及CD4^(+)/CD8^(+)均低于体检健康组(P<0.05)。高危组外周血CD3^(+)、CD4^(+)T淋巴细胞比例及CD4^(+)/CD8^(+)均低于非高危组(P<0.05)。FMS样酪氨酸激酶3-内部串联重复基因(FLT3-ITD)突变阳性者外周血CD3^(+)、CD4^(+)T淋巴细胞表达水平高于FLT3-ITD突变阴性者(P<0.05);核仁磷酸蛋白基因1(NPM1)突变阳性者外周血CD4^(+)T淋巴细胞表达水平高于NPM1突变阴性者(P<0.05)。CR组外周血CD3^(+)、CD4^(+)T淋巴细胞比例及CD4^(+)/CD8^(+)均高于未CR组(P<0.05)。结论AML患者随着病情进展,可致外周血T淋巴细胞亚群表达水平降低而引起机体免疫功能失衡,且FLT3-ITD、NPM1突变阳性均可导致外周血T淋巴细胞亚群表达水平异常,临床疗效较好的AML患者外周血T淋巴细胞亚群表达水平可见明显升高。

Objective To analyze the expression level of T lymphocyte subsets in peripheral blood of patients with acute myeloid leukemia(AML)and its relationship with clinicopathological features.Methods A total of 85 patients with AML treated in the hospital from March 2019 to March 2021 were retrospectively selected as the AML group,and further divided into the high-risk group(25 cases)and the non-high-risk group(60 cases)according to the chromosomal examination.Another 85 healthy check-ups in the same period were included in the healthy group.All patients with AML were treated with standard induction regimen and were divided into the complete remission(CR)group(55 cases)and the non-CR group(30 cases)according to clinical efficacy.The expression level of T lymphocyte subsets in peripheral blood was detected and compared between the AML group and the healthy group,high-risk group and non-high-risk group,CR group and non-CR group,and the relationship between the expression level of peripheral blood T lymphocyte subsets and clinicopathological features of patients with AML was analyzed.Results The expression levels of CD3^(+),CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)in peripheral blood of the AML group were lower than those of the healthy group(P<0.05).The expression level of CD3^(+),CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)in the high-risk group were lower than those in the non-high-risk group(P<0.05).The expression levels of CD3^(+),CD4^(+)T lymphocytes in peripheral blood of FMS-like tyrosine kinase 3-internal tandem repeat gene(FLT3-ITD)mutation positive patients were higher than those of FLT3-ITD mutation negative patients(P<0.05).The expression level of CD4^(+)T lymphocytes in peripheral blood of patients with nucleolar phosphoprotein gene 1(NPM1)mutation was higher than that of patients with NPM1 mutation(P<0.05).The expression levels of CD3^(+),CD4^(+)T lymphocytes and CD4^(+)/CD8^(+)in peripheral blood of the CR group were higher than those of the non-CR group(P<0.05).Conclusion With the progression of AML,the expression level of T lymphocyte subsets in peripheral blood could decrease,which will lead to the imbalance of immune function.Moreover,positive mutations of FLT3-ITD and NPM1 could lead to abnormal expression level of T lymphocyte subsets,and the expression level of T lymphocyte subsets in AML patients with good clinical efficacy could be significantly increased.