CAJ | 학술논문

目地检测弥漫大B细胞淋巴瘤(DLBCL)患者两种预后亚型(生发中心型和非生发中心型)不同治疗阶段的T细胞亚群分布,评估患者的T细胞免疫功能状态.方法采用流式细胞术(FCM)检测34例DLBCL患者发病初、化疗期间、疗程结束后外周血中的CD3+、CD4+、CD8+和CD4+CD2.5+T细胞的分布情况.以16名健康人外周血作为对照.结果 DLBCL两种预后亚型患者化疗前外周血中CD4+T细胞比例和CD4/CD8比值分别为(32.27±2.00)％和(0.81 ±0.39),明显低于正常水平；CD8+T细胞、CD4+ CD25+T细胞比例分别为(40.80±6.23)％和(5.68±5.45)％,明显增高.而CD3+T细胞比例则在整个治疗过程中保持稳定状态,与正常水平比较差异均无统计学意义(均P＞ 0.05).化疗3个周期后CD8+T细胞逐渐减少,而CD4+、CD4+ CD25+T细胞、CD4/CD8比值则明显上升,至化疗6个周期结束后除了CD4+CD25+T细胞仍明显高于正常及化疗前水平外,余各项指标与正常水平比较差异均无统计学意义(均P＞ 0.05).至化疗结束3个月后,CD4+CD25T细胞逐渐下降至接近正常,除了化疗前生发中心型CD3+和CD8+T细胞比例[分别为(74.83±3.59)％和(40.80±6.23)％]高于非生发中心型[分别为(68.26±3.56)％和(33.76±5.46) ％],不同治疗时期DLBCL患者两种预后亚型间各项指标差异均无统计学意义(t值分别为2.039、2.419,P值分别为0.041、0.018).不同时期DLBCL患者两种预后亚型间各指标差异均无统计学意义(均P＞ 0.05).结论不同基因亚型DLBCL患者不同治疗时期均存在不同程度的细胞免疫受抑,动态监测T细胞亚群的变化可以实时了解患者的T细胞免疫功能状况.
목지 검측미만대B세포림파류(DLBCL)환자량충예후아형(생발중심형화비생발중심형)불동치료계단적T세포아군분포,평고환자적T세포면역공능상태.방법 채용류식세포술(FCM)검측34례DLBCL환자발병초、화료기간、료정결속후외주혈중적CD3+、CD4+、CD8+화CD4+CD2.5+T세포적분포정황.이16명건강인외주혈작위대조.결과 DLBCL량충예후아형환자화료전외주혈중CD4+T세포비례화CD4/CD8비치분별위(32.27±2.00)％화(0.81 ±0.39),명현저우정상수평；CD8+T세포、CD4+ CD25+T세포비례분별위(40.80±6.23)％화(5.68±5.45)％,명현증고.이CD3+T세포비례칙재정개치료과정중보지은정상태,여정상수평비교차이균무통계학의의(균P＞ 0.05).화료3개주기후CD8+T세포축점감소,이CD4+、CD4+ CD25+T세포、CD4/CD8비치칙명현상승,지화료6개주기결속후제료CD4+CD25+T세포잉명현고우정상급화료전수평외,여각항지표여정상수평비교차이균무통계학의의(균P＞ 0.05).지화료결속3개월후,CD4+CD25T세포축점하강지접근정상,제료화료전생발중심형CD3+화CD8+T세포비례[분별위(74.83±3.59)％화(40.80±6.23)％]고우비생발중심형[분별위(68.26±3.56)％화(33.76±5.46) ％],불동치료시기DLBCL환자량충예후아형간각항지표차이균무통계학의의(t치분별위2.039、2.419,P치분별위0.041、0.018).불동시기DLBCL환자량충예후아형간각지표차이균무통계학의의(균P＞ 0.05).결론 불동기인아형DLBCL환자불동치료시기균존재불동정도적세포면역수억,동태감측T세포아군적변화가이실시료해환자적T세포면역공능상황.
Objective To detect the distribution of T lymphocyte subpopulations at different stages of treatment in diffuse large B-cell lymphoma (DLBCL) patients with distinct gene subtypes (GCB and non-GCB),.thereby to evaluate the status of T-cell immunity.Methods Expression of CD3+,CD4+,CD8+,CD4+ CD25+ on T lymphocytes of 34 DLBCL patients was detected by flow cytometry (FCM) before,during,and after chemotherapy.16 normal individuals served as the controls.Results The proportion of CD4+ T cells and the ratio of CD4+/CD8+ before chemotherapy were (32.27±2.00) ％ and (0.81±0.39) ％,respectively,and were lower than those in the healthy controls.In addition,CD8+ and CD4+ CD25+ T cells were (40.8±6.23) ％ and (5.68± 5.45) ％,higher than the controls.Further,CD3+ T cells kept constant through the different stages of treatment,with no statistically significant difference when compared to the normal level.CD8+ T cells were decreased gradually,while CD4+ and CD4+ CD25+ T cells,and the ratio of CD4+/CD8+ were raised dramatically.Except the CD4+CD25+,all T cell subpopulations came back to the basal level after sixth cycles of chemotherapy.The difference of T cell subpopulations between GCB and non-GCB DLBCL patients was not statistically significant,except the respective proportions of CD3+ and CD8+ T cells (74.83±3.59) ％ and (40.8±6.23) ％ in GCB DLBCL patients before chemotherapy were higher than those in the non-GCB DLBCL patients [(68.26±3.56) ％ and (33.76± 5.46) ％] (t =2.039,2.419,P =0.041,0.018).CD4+ CD2.5+ T cells were decreased gradually and restored to the baseline 3 months after the last cycle of chemotherapy,while they were obviously lower in the GCB DLBCL patients (t =2.481,P =0.035).Conclusion There is cellular immunosuppression to some extent at different stages of treatment in DLBCL patients with distinct gene subtypes.It is thus necessary to monitor the changes in T lymphocyte subpopulations to timely estimate the T-cell immune function.