白血病患者化疗前后调节性T细胞的表达与微小残留白血病的关系  

Correlation between Regulatory T Cell Express and Minimal Residual Leukemia before and after Chemotherapy

作　　者：路萍[1] 侯十前[1] 王永志[1] 范秋兰[1] 罗朝蕊[1] 陈景华[1] 

机构地区：[1]玉溪市人民医院血液科,云南玉溪653100

出　　处：《昆明医科大学学报》2015年第4期93-96,113,共5页Journal of Kunming Medical University

摘　　要：目的 探讨急性白血病患者Treg细胞与MRD的关系及其临床意义.方法 对2012年至2014年在玉溪市人民医院血液科规律诊治的53例急性白血病患者利用流式细胞术进行MRD、Treg细胞检测,从首次诱导缓解治疗结束后第14天开始,每3~6月检测1次,并动态监测,对治疗前后、不同疾病组别、不同危险度Treg细胞进行比较分析,并分析MRD阴性、MRD阳性组Treg细胞表达差别.结果 AL患者诱导缓解前Treg细胞明显高于治疗缓解后、正常对照组（P〈0.01）,ANLL与ALL组间治疗前后Treg细胞无明显差别,高危组Treg细胞明显高于低危组（P〈0.01）,与中危组无明显差别,而中危组与低危组无明显差别,MRD阴性组复发率明显低于MRD阳性组（P〈0.01）,MRD阳性组Treg细胞明显高于MRD阴性组（P〈0.01）.结论 初诊白血病患者体内Treg细胞明显增高,且恶性程度越高,Treg细胞水平越高,治疗缓解后Treg细胞水平明显下降,接近正常水平,MRD阳性患者Treg细胞明显高于MRD阴性患者,提示Treg细胞可能抑制机体对肿瘤细胞的免疫杀伤,对白血病患者判断预后、评估疗效、预测疾病复发、改善治疗方案,有着十分积极的作用和临床应用价值.Objective The study was aimed to detect bone marrow minimal residual disease （MRD） and regulatory T cell （Treg） in newly diagnosed acute leukemia （AL） and after chemotherapy, and analyze the relationship between Treg with MRD. Methods 53 cases of specimens in patients with acute leukemia were collected, and MRD and Treg were detected by muhiparameter flow cytometry （FCM） . From the beginning of induction chemotherapy by CR, every 3-6 months detection time, the relationship between Treg and MRD and expression of different treatment times/disease groups/risks were analyzed and compared. Results The expression of Treg in initial treatment AL patients was higher than in patients after chemotherapy and normal control （P 〈 0.01） There was no difference in the expression of Treg between group ANLL and group ALL （P 〉 0.05） . High risk group was higher than low risk （P 〈 0.01） , and there were no differences between high/low risk groups and intermediate risk group （P 〉 0.05） . AL patients with MRD positive had a higher rate of recurrence than MRD negative patients （P 〈 0.01） , expression of Treg in MRD positive patients was higher than that in MRD negative patients （P 〈 0.01） Conclusion Treg could increase in newly diagnosed leukemia patients, and it has the higher expression when the higher grade malignancy. Treg will fall after chemotherapy and close to the normal, expression of Treg in MRD positive patient is higher than MRD negative patients. Perhaps, Treg could suppress the body immune killer for tumor ceils, which has clinical significance on the prognosis, evaluation, recurrence and treatment of AL patients.

关 键 词：调节性T细胞 微小残留病 白血病 

分 类 号：R557[医药卫生—血液循环系统疾病]