CAJ | 학술논문

目的探讨弥漫大B细胞淋巴瘤(DLBCL)患者细胞免疫状态与国际预后指数(IPI)的关系.方法初治DLBCL患者52例,按照IPI积分分为4组(低危组17例、低中危组16例、中高危组12例、高危组7例),采用流式细胞术检测各DLBCL组与健康对照组(43例)T淋巴细胞亚群(包括CD3+、CD3+CD4+、CD3+CD8+)、NK细胞的绝对计数值及CD4+/CD8+,各组间比较并分析IPI的5个指标与各T淋巴细胞亚群绝对值的相关性.结果 DLBCL高危组的CD3+细胞(1570.9±370.5)个/μl,较其他IPI组高；DLBCL 4组的CD4+细胞数均低于健康对照组的(751.3±367.4)个/μl;DLBCL高危组的CD8+细胞(1055.9±523.8)个/μl,较健康对照组及其他IPI分组明显升高；中高危组与高危组的CD4+/CD8+比值(1.0±0.2、0.7±1.0)降低明显,与健康对照组、低危组、低中危组比较差异均有统计学意义( P＜0.05)；中高危组与高危组NK细胞较健康对照组明显降低[(199.5±68.4)/μl、(171.9±126.9)/μl].淋巴瘤患者的年龄、临床分期、全身状态与患者外周血T淋巴细胞亚群中的CD3+细胞数、CD8+细胞数以及CD4+/CD8+比值有相关性.结论初治的DLBCL患者细胞免疫状态与IPI有关；随着IPI积分的增加,DLBCL患者免疫抑制与紊乱加重,NK细胞功能越差,预后也更差.
목적 탐토미만대B세포림파류(DLBCL)환자세포면역상태여국제예후지수(IPI)적관계.방법 초치DLBCL환자52례,안조IPI적분분위4조(저위조17례、저중위조16례、중고위조12례、고위조7례),채용류식세포술검측각DLBCL조여건강대조조(43례)T림파세포아군(포괄CD3+、CD3+CD4+、CD3+CD8+)、NK세포적절대계수치급CD4+/CD8+,각조간비교병분석IPI적5개지표여각T림파세포아군절대치적상관성.결과 DLBCL고위조적CD3+세포(1570.9±370.5)개/μl,교기타IPI조고；DLBCL 4조적CD4+세포수균저우건강대조조적(751.3±367.4)개/μl;DLBCL고위조적CD8+세포(1055.9±523.8)개/μl,교건강대조조급기타IPI분조명현승고；중고위조여고위조적CD4+/CD8+비치(1.0±0.2、0.7±1.0)강저명현,여건강대조조、저위조、저중위조비교차이균유통계학의의( P＜0.05)；중고위조여고위조NK세포교건강대조조명현강저[(199.5±68.4)/μl、(171.9±126.9)/μl].림파류환자적년령、림상분기、전신상태여환자외주혈T림파세포아군중적CD3+세포수、CD8+세포수이급CD4+/CD8+비치유상관성.결론 초치적DLBCL환자세포면역상태여IPI유관；수착IPI적분적증가,DLBCL환자면역억제여문란가중,NK세포공능월차,예후야경차.
Objective To explore the relationship between the international prognosis indexes(IPT) and the cell-mediated immunity condition in DLBCL patients. Methods 52 DLBCL patients were divided into 4 groups and the FCM was used to examine the T lymphocyte subsets,including CD3+、CD4+、CD8+、NK cells.T lymphocyte subsets absolute value and CD4+/CD8+ ratio were examined. Correlation with IPI were compared among groups.Results CD3+ cells in high risk group [(1570.9±370.5)/μl]were higher than other IPI groups;CD4+ cells in DLBCL groups were all lower than normal group(751.3±367.4)/μl]; CD8+ cells in high risk group [(1055.9±523.8)/μl] were higher than other groups; CD4+/CD8+ ratio in middle-high risk group and high risk group (1.0±0.2、0.7±1.0) were lower than other IPI groups and normal group; NK cells in middle-high risk group and high risk group were lower than the normal group [(199.5±68.4)/μl、(171.9±126.9)/μl]; Age,clinical stage,body state had correlated with the CD3+ 、CD8+ cells and CD4+/CD8+ ratio of the DLBCL patients' peripheral blood T lymphosyte subsets. Conclusions The immunity condition in DLBCL patients has correlated with IPI; With increasing IPI value,the immunity depression and disorder become more serious,NK cells function become worse,and the prognosis is bad too.