CAJ | 학술논문

目的：探讨CD4+CD25+Foxp3+/CD4+CD25+检测与急性髓系白血病的发病机制、治疗效果及预后的关系，并与CD4+CD25+/CD4+法比较两种检测方法是否存在差异。方法应用流式细胞术法分别检测41例初治AML患者(初治组)、11例一次化疗缓解的患者(化疗敏感组)、9例两次以上化疗不缓解的患者(化疗耐药组)、13例化疗缓解后一直没有复发的患者(持续缓解组)、8例化疗缓解后又再次复发的患者(复发组)和20例健康体检者(对照组)CD4+CD25+Foxp3+/CD4+CD25+及CD4+CD25+/CD4+在外周血中的比例。结果与对照组相比较， AML患者初治组两类细胞比例均较正常人明显升高(P＜0.01)，初治患者组两种检测方法间存在显著差异(P＜0.01)。与化疗缓解组比较，化疗耐药组两种检测方法检测的比例均明显升高(P＜0.01)，耐药患者组两种方法间存在显著差异(P＜0.01)。与持续缓解组比较，复发组患者的比例明显升高(P＜0.01)，复发组两种方法间存在显著差异(P＜0.01)。结论急性髓系白血病患者外周血中CD4+CD25+Foxp3+/CD4+CD25+与急性髓系白血病的发生相关，并且检测其比例能预测白血病患者对化疗药物的反应及预后，且其灵敏度高于CD4+CD25+/CD4+检测法，而其特异性与CD4+Foxp3+/CD4+检测法一致。
목적：탐토CD4+CD25+Foxp3+/CD4+CD25+검측여급성수계백혈병적발병궤제、치료효과급예후적관계，병여CD4+CD25+/CD4+법비교량충검측방법시부존재차이。방법응용류식세포술법분별검측41례초치AML환자(초치조)、11례일차화료완해적환자(화료민감조)、9례량차이상화료불완해적환자(화료내약조)、13례화료완해후일직몰유복발적환자(지속완해조)、8례화료완해후우재차복발적환자(복발조)화20례건강체검자(대조조)CD4+CD25+Foxp3+/CD4+CD25+급CD4+CD25+/CD4+재외주혈중적비례。결과여대조조상비교， AML환자초치조량류세포비례균교정상인명현승고(P＜0.01)，초치환자조량충검측방법간존재현저차이(P＜0.01)。여화료완해조비교，화료내약조량충검측방법검측적비례균명현승고(P＜0.01)，내약환자조량충방법간존재현저차이(P＜0.01)。여지속완해조비교，복발조환자적비례명현승고(P＜0.01)，복발조량충방법간존재현저차이(P＜0.01)。결론급성수계백혈병환자외주혈중CD4+CD25+Foxp3+/CD4+CD25+여급성수계백혈병적발생상관，병차검측기비례능예측백혈병환자대화료약물적반응급예후，차기령민도고우CD4+CD25+/CD4+검측법，이기특이성여CD4+Foxp3+/CD4+검측법일치。
Objective To explore the significance of CD4+CD25+Foxp3+Tregs detection in the pathogenesis, curative effect and prognosis of acute leukemia, and compare it with the method of CD4+CD25+/CD4+detection and determine whether there is differ-ence between the two methods. Methods The proportion of CD4+CD25+Foxp3+Tregs cells in the peripheral blood were tested in 41 cases of untreated patients with AML (Initial treatment group), 11 cases of remission-patients after one period of chemotherapy (Chemotherapy sensitive group), 9 cases of non-remission-patients after two period of chemotherapy (Chemotherapy resistance group), 13 cases of recurrence-free-patients achieving chemotherapy remission (Sustained remission group),8 relapsed patients achieving Chemotherapy remission (Relapse group), 20 cases of healthy donators (control group) by using flow cytometry, and the proportion of CD4+CD25+Foxp+Tregs cells in the peripheral blood with the method of CD4+CD25+Foxp3+/CD4+CD25+and CD4+CD25+/CD4+were detected. Results The proportion of CD4+CD25+Foxp3+Tregs cells in the peripheral blood of initial treatment group was greatly higher than that of control group, but there was no difference between the two methods of CD4+CD25+Foxp3+/ CD4+CD25+and CD4+CD25+/CD4+ detection. The proportion of CD4+CD25+Foxp3+ Tregs cells in the peripheral blood of chemotherapy resis-tance group was greatly higher than that of chemotherapy sensitive group, but there was no difference between the two methods of CD4+CD25+Foxp3+/CD4+CD25+and CD4+CD25+/CD4+detection in the chemotherapy resistance group and chemotherapy sensitive group. The proportion of CD4+CD25+Foxp3+Tregs cells in the peripheral blood of relapse group was greatly higher than that of sus-tained remission group, but there was no difference between the two methods of CD4+CD25+Foxp3+/CD4+CD25+and CD4+CD25+/CD4+ detection in the relapse group and sustained remission group. Conclusions The significant increased rate of CD4+ CD25+Foxp3+Tregs cells in peripheral blood of AML patients may be related to the occurrence of leukemia and the detection of the pro- portion of CD4+CD25+Foxp3+Tregs can predict prognosis and re-sponse to chemotherapy in patients with leukemia. And its detec-tion sensitivity is higher than that of the CD4+CD25+/CD4+detec-tion method, but its specificity is consistant with the method of CD4+Foxp3+/CD4+assay.