急性淋巴细胞白血病患者外周血滤泡辅助性T细胞亚群比例、血清细胞因子水平变化及其相关性

Proportion of Tfh cell subsets in peripheral blood and serum cytokine levels in patients with acute lymphoblastic leukemia and their correlation

目的观察急性淋巴细胞白血病(ALL)患者外周血滤泡辅助性T细胞(Tfh)亚群比例、血清细胞因子水平变化,分析两者间及其与患者预后的关系。方法选取初治ALL患者30例(观察组,根据ALL患者预后危险分层标准分为预后良好者13例和预后不良者17例)和同期健康体检者20例(对照组),采用流式细胞术检测两组外周血Tfh亚群比例(Tfh、Tfh1、Tfh2、Tfh17),ELISA法检测血清细胞因子(IFN-γ、IL-4、IL-17),Pearson相关分析法分析观察组外周血Tfh亚群比例与血清细胞因子水平的相关性。结果与对照组比较,观察组外周血Tfh、Tfh2比例增加,Tfh1比例减小(P均<0.05);与预后不良者比较,观察组预后良好者Tfh、Tfh2比例减小(P均<0.05)。与对照组比较,观察组血清IFN-γ水平降低,血清IL-4水平升高(P均<0.05);与预后不良者比较,观察组预后良好者血清IFN-γ水平升高,血清IL-4水平降低(P均<0.05)。观察组Tfh、Tfh2比例与ALL患者血清IL-4水平呈正相关(r分别为0.860、0.965,P均<0.05),Tfh比例与血清IFN-γ水平呈负相关(r为-0.289,P<0.05)。结论ALL患者外周血Tfh及Tfh2比例增加和Tfh1比例减小,血清IFN-γ水平降低和IL-4水平升高,其与患者预后不良有一定的关系,可能参与了ALL的免疫功能紊乱,并且增强了免疫抑制作用,参与了疾病进展。

Objective To observe the proportion of peripheral blood T follicular helper(Tfh)cell subsets and serum cytokine levels in patients with acute lymphoblastic leukemia(ALL),and to analyze the relationship between the two and their relationship with the prognosis of patients.Methods Thirty newly treated ALL patients(observation group,including13 patients with good prognosis and 17 patients with poor prognosis according to the risk stratification criteria for ALL patients)and 20 healthy subjects(control group)were selected.Flow cytometry was used to detect the proportion of Tfh cell subgroups(Tfh,Tfh1,Tfh2,Tfh17)in the peripheral blood of the two groups.Serum cytokine levels[interferon-γ(IFN-γ),interleukin(IL)-4,IL-17]were detected by ELISA,and the correlation between the proportion of Tfh subsets in peripheral blood and serum cytokine level in the observation group was analyzed by Pearson correlation analysis.Results Compared with the control group,the proportions of Tfh and Tfh2 in peripheral blood increased,and the proportion of Tfh1 decreased in the observation group(all P<0.05).Compared with those with poor prognosis,the proportions of Tfh and Tfh2 decreased in the observation group with good prognosis(both P<0.05).Compared with the control group,the serum IFN-γlevel decreased and serum IL-4 level increased in the observation group(both P<0.05).Compared with those with poor prognosis,the serum IFN-γlevel increased and serum IL-4 level decreased in patients with good prognosis in the observation group(both P<0.05).The proportions of Tfh and Tfh2 in the observation group were positively correlated with the serum IL-4 level of ALL patients(r=0.860 and 0.965,respectively;both P<0.05),and the proportion of Tfh was negatively correlated with the serum IFN-γlevel(r=–0.289,P<0.05).Conclusion In ALL patients,the proportions of Tfh and Tfh2 in peripheral blood increase,the proportion of Tfh1 decreases,the level of serum IFN-γdecreases,and the level of IL-4 increases,which are related to the poor prognosis of patients,and they may participate in the immune dysfunction of ALL,enhance the immunosuppressive effect,and participate in the disease progression.