CD14＋HLA-DRlow／-单核细胞在非霍奇金淋巴瘤患者外周血中的表达及其意义  

Expression of CD14 ＋ HLA-DRlow/- monocytes in peripheral blood of patients with non-Hodgkin lymphoma and its significance

作　　者：修冰[1] 邱宇[3] 郑伟萍 王秀芹[1] 丁懿[1] 李萍[1] 陈毓华[1] 吴昊[1] 张文君[1] 梁爱斌[1] 杨志章 Ansell Stephen 

机构地区：[1]同济大学附属同济医院血液科,上海200065 [2]温州市中心医院肿瘤化疗科,325000 [3]同济大学附属同济医院检验科,上海200065 [4]DepartmentofHematology,MayoClinic,Rochester,Minnesota55905,USA

出　　处：《白血病．淋巴瘤》2016年第11期645-650,共6页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金青年基金（81600156）;上海申康医院发展中心新兴前沿技术项目（SHDC12015108）

摘　　要：目的：评估初发非霍奇金淋巴瘤（NHL）患者治疗前的免疫功能，并与患者临床特点及治疗效果进行比对，寻找判断预后的免疫靶标。方法收集37例初发NHL患者和28名健康对照者外周血，采用流式细胞术检测不同免疫细胞的绝对数及相对比例。同时收集患者临床资料，进行统计学分析。结果初发NHL患者外周血单核细胞绝对数高于健康对照者（536.20×10^9／μl比374.90×10^9／μl， P＜0.01），经典型单核细胞（CD14＋＋CD16-）的绝对数高于健康对照者（502.30×10^9／μl比325.10×10^9／μl， P＜0.01）；初发NHL患者淋巴细胞绝对计数与单核细胞绝对计数比值（ALC／AMC）低于健康对照者（1.62比2.45，P＜0.01）。初发NHL患者各单核细胞亚群HLA-DR的表达水平均低于健康对照者，其中两组间中间型单核细胞（CD14＋＋CD16＋）和非经典型单核细胞（CD14＋CD16＋＋）的HLA-DR表达强度差异有统计学意义[25.43平均荧光强度（MFI）比33.52 MFI，11.40 MFI比15.70 MFI，均P＜0.01]。CD14＋HLA-DRlow／-单核细胞的相对比例与患者的性别、病理类型、是否获得缓解及复发无关（P＞0.05），但年龄低于中位年龄（57.8岁）的患者CD14＋HLA-DRlow／-单核细胞比例高于年龄大于中位年龄的患者（43.83%比23.85%，P＜0.01）。Ann Arbor Ⅲ～Ⅳ期患者CD14＋HLA-DRlow／-单核细胞的比例高于Ⅰ～Ⅱ期患者（41.51%比18.40%，P＜0.01），国际预后指数（IPI）3～4分的患者高于1～2分的患者（52.5%比18.47%， P＜0.01）。结论 NHL患者外周血单核细胞CD14＋HLA-DRlow／-提示预后不良，检测CD14＋HLA-DRlow／-单核细胞对于评估患者疾病进展、预测患者预后具有重要的参考价值。Objective To assess the immune function of newly diagnosed patients with non-Hodgkin lymphoma （NHL）, and to compare the results with clinical data and the treatment effect to seek new immune targets related to prognosis. Methods The peripheral blood samples from 37 cases of new untreated NHL patients and 28 cases of healthy controls were collected.The absolute counts and relative proportion of different immune cells were detected by flow cytometry. The clinical data of the patients and controls were collected and software was used to do statistical analysis. Results The absolute number of monocyte was higher in NHL patients compared with healthy controls （536.20 ×10^9/μl vs. 374.90 ×10^9/μl, P＆lt;0.01）. The classical CD14＋＋CD16-monocyte counts were higher in NHL patients compared with healthy controls （502.30×10^9/μl vs. 325.10×10^9/μl, P＆lt;0.01）. The ratio of absolute lymphocyte count to absolute monocyte count （ALC/AMC） was decreased in NHL patients compared with healthy controls （1.62 vs. 2.45, P＆lt;0.01）. HLA-DR expression was decreased on each subtype of monocyte of NHL patients, among which the difference of intermediate monocyte （CD14＋＋CD16＋） （25.43 MFI vs. 33.52 MFI, P＆lt;0.01） and non-classical monocyte （CD14＋CD16＋＋） （11.40 MFI vs. 15.70 MFI, P＆lt;0.01） were of statistical significance. The ratio of CD14＋HLA-DRlow/- monocyte was not associated with the patient＆#39;s gender, pathological type, remission or relapse. For NHL patients, the ratio of CD14＋HLA-DRlow/- monocyte in age below 57.8 years was higher than that of patients with age above 57.8 years （43.83 % vs. 23.85 %, P＆lt;0.01）. The ratio of CD14＋HLA-DRlow/-monocyte in patients with Ann Arbor stageⅢ-Ⅳwas higher than that of patients with Ann Arbor stage Ⅰ-Ⅱ（41.51%vs. 18.40%, P＆lt;0.01）;The ratio of CD14＋HLA-DRlow/-monocyte in patients with IPI score 3-4 points was higher than that of patients with IPI score 1-2 points （52.5%vs. 18.47%, P＆lt;0.01

关 键 词：淋巴瘤 非霍奇金 单核细胞 HLA-DR抗原 

分 类 号：R733.1[医药卫生—肿瘤]