多发性骨髓瘤患者T细胞亚群CD28表达及其临床意义  

Expression of CD28 molecules on T lymphocyte subsets in multiple myeloma

作　　者：贾丽[1] 邱国强[1] 谢晓宝[1] 

机构地区：[1]苏州大学医学院附属第三医院血液科,江苏常州213003

出　　处：《临床荟萃》2008年第23期1692-1694,共3页Clinical Focus

摘　　要：目的通过检测多发性骨髓瘤(MM)患者T细胞亚群CD28表达,探讨其T细胞免疫功能状态及临床意义。方法采用流式细胞术检测38例MM患者及20例健康对照外周血T细胞亚群CD28表达。结果①Ⅲ期MM患者CD4+T细胞较对照组及Ⅰ、Ⅱ期患者降低,为(29.1±7.7)%vs(37.2±5.9)%(、36.7±7.6)%、(36.4±6.4)%(P<0.05或<0.01);Ⅱ、Ⅲ期患者CD8+T细胞均高于对照组,为(38.0±6.4)%、(37.1±9.7)%vs(31.8±5.4)%(均P<0.05);Ⅲ期患者CD4+/CD8+比值较对照组及Ⅰ期患者降低,为0.8±0.3 vs 1.2±0.3、1.2±0.3(P<0.05或<0.01);CD4+CD28+、CD8+CD28+细胞在Ⅲ期患者均显著低于对照组及Ⅰ、Ⅱ期患者,分别为(25.0±8.2)%vs(35.3±5.6)%、(35.1±8.0)%(、33.8±5.7)%;(10.8±4.1)%vs(17.0±4.3)%、(18.3±4.8)%(、18.2±4.6)%(均P<0.01)。②进展期MM患者CD4+T细胞及CD4+/CD8+比值均低于对照组,分别为(32.0±8.3)%vs(37.2±5.9)%;0.9±0.3 vs 1.2±0.3(P<0.05或<0.01);CD8+T细胞比对照组增高,为(36.8±8.6)%vs(31.8±5.4)%(P<0.05),而其CD4+CD28+、CD8+CD28+细胞在进展期MM患者均低于对照组和稳定期,分别为(28.3±8.6)%vs(35.3±5.6)%(、35.6±7.4)%;(13.1±4.9)%vs(17.0±4.3)%(、20.5±5.9)%(P<0.05或<0.01)。③CD4+CD28+细胞百分率与β2微球蛋白水平呈负相关(r=-0.401,P<0.05)。结论MM患者存在T细胞亚群CD28表达缺陷,并与临床分期、病情进展及预后相关。Objective To evaluate the changes and the clinical significance of T lymphocytes expressing CD28 in patients with multiple myeloma（MM）. Methods T lymphocyte subsets and CD28 positive T lymphocytes in peripheral blood of 38 patients with MM and 20 healthy donors were measured by flow cytometry. Results （1）The proportion of CD4＋T cells was lower in stage Ⅲ MM than that in controls,stage Ⅰand stage Ⅱ MM, （29.1±7.7）% vs （37.2± 5.9） ,（36.7±7.6）%,（36.4±6.4） %（ P 〈0.05 or 〈0.01）. The proportion of CD8^＋ T cells,either in stage Ⅱ MM or in stages Ⅲ MM,was higher than that in controls,（38.0±6.4）%,（37.1±9.7）% vs （31.8±5.4）%（allP〈0.05）. CD4^＋/CD8^＋ ratio was lower in stage Ⅲ MM than that in controls and stage Ⅰ MM,0.8±0.3 vs 1.2±0.3, 1.2±0.3（ P 〈0.05 or 〈0.01）. Both the percentages of CD4^＋ CD28^＋ and CD8^＋ CD28^＋ cells were lower in stage Ⅲ MM than that in controls , stage Ⅰ and stage Ⅱ MM,（25.0±8.2）% vs （35.3±5.6）%,（35.1±8.0）%;（33.8± 5.7）%;（10.8±4.1）% vs （17.0±4.3）%,（18.3±4.8）%,（18.2±4.6）% respectively（allP〈0.01）. （2）Both the proportion of CD4^＋T cells and CD4^＋/CD8^＋ ratio were lower in active MM than that in controls, （32.0±8.3）% vs （37.2±5.9） % ;0.9±0.3 vs 1.2±0.3 respectively（ P 〈0.05 or 〈0.01）. The proportion of CD8^＋ T cells was higher in active MM than that in controls, （36.8 ± 8.6）% vs （31.8 ±5.4） % （ p 〈 0.05）. The percentages of CD4^＋ CD28^ ＋ and CD8^＋ CD28^＋ cells were lower in active MM than that in controls and stable MM, （28.3 ± 8.6）% vs （35.3 ± 5.6）%,（35.6±7.4）%;（13.1±4.9）% vs （17.0±4.3）%, （20.5±5.9）% respectively（ P 〈0.05 or 〈0.01）. The levels of CD4^＋ CD28^＋ and CD8^＋ CD28^＋ cells in stable MM patients were not different from controls（ P 〉0.05）. （3）The proportion of CD4^＋ CD28^＋ cells was negatively correlated with the level of β2-MG（ r =-0.

关 键 词：多发性骨髓瘤 T淋巴细胞亚群 抗原 CD28 

分 类 号：R733.303[医药卫生—肿瘤]