FCR方案治疗的慢性淋巴细胞白血病患者血清IFN-γ、IL-4、IL-17及TGF-β水平变化  

Alteration of IFN-γ,IL-4,IL-17 and TGF-β levels in Serum of Patients with Chronic Lymphocytic Leukemia Treated with FCR

作　　者：陈丽红 单坤生 吴珮琳 严政威 王玮 

机构地区：[1]解放军第一七五医院血液科,福建漳州363000

出　　处：《中国实验血液学杂志》2017年第6期1615-1620,共6页Journal of Experimental Hematology

摘　　要：目的:探讨FCR方案治疗前后慢性淋巴细胞白血病(CLL)患者血清中干扰素-γ(IFN-γ)、白介素-17(IL-17)、白介素-4(IL-4)和转化生长因子-β(TGF-β)水平变化及其临床意义。方法:选择接收过FCR方案治疗的CLL患者共计47例,30例健康体检者作为对照组,应用ELISA检测CLL患者治疗前后及对照组血清IFN-γ、IL-4、IL-17和TGF-β的水平。比较各组间IFN-γ、IL-4、IL-17和TGF-β水平、IFN-γ/IL-4比值及TGF-β/IL-17比值的差异。结果:CLL组患者治疗前IL-4、IL-17和TGF-β水平、TGF-β/IL-17比值均高于对照组,而IFN-γ水平及IFN-γ/IL-4比值均低于对照组(P<0.05);经过FCR方案治疗后,IL-4、IL-17和TGF-β水平、TGF-β/IL-17比值较治疗前明显下降(P<0.05),IFN-γ水平及IFN-γ/IL-4比值较治疗前明显上升(P<0.05)。治疗后的IL-4、IL-17水平、TGF-β/IL-17、IFN-γ/IL-4比值与对照组比较无明显差异(P>0.05),仅IFN-γ、TGF-β水平与对照组比较仍有统计学差异(P<0.05)。在Binet A期、B期和C期分期中,随着Binet分期进展,CLL患者血清IFN-γ、IL-17水平和IFN-γ/IL-4比值逐渐减低,血清IL-4水平、TGF-β/IL-17比值逐渐增高,治疗前CLL患者IFN-γ/IL-4比值与Binet分期均呈负相关(r=-0.53),TGF-β/IL-17比值与Binet分期均呈正相关(r=0.46)。根据治疗效果分组分析发现,治疗效果良好的CR组和PR组血清中IFN-γ、IL-4、IL-17、TGF-β水平、IFN-γ/IL-4、TGF-β/IL-17比值与治疗前比较,差异有统计学意义(P<0.05),而SD组和PD组与治疗前比较,差异无统计学意义(P>0.05)。结论:随着疾病进展,CLL患者IFN-γ/IL-4比值逐渐减低,TGF-β/IL-17比值逐渐增高,而FCR方案治疗可以克服这一趋势,动态监测IFN-γ/IL-4、TGF-β/IL-17比值的变化情况,因而可以指导临床治疗。Objective： To investigate the alteration and clinical significance of IFN-γ,IL-4,IL-17 and TGF-β levels in serum of patients with chronic lymphocytic leukemia treated with FCR. Methods： Forty-seven CLL patients treated with FCR regimen were enrolled in CLL group,meanwhile 30 healthy persons were selected in control group. The serum levels of IFN-γ,IL-4,IL-17 and TGF-β were detected by ELISA in CLL group before and after treatment and in control group,then the differences of IFN-γ,IL-4,IL-17 and TGF-β levels as well as IFN-γ/IL-4 ratio and TGF-β/IL-17 ratio were compared between 2 groups. Results： Before treatment with PCR regimen,the IL-4,IL-17 and TGF-β levels as well as TGF-β/IL-17 in CLL group were higher than those in control group（ P〈0. 05）,while the IFN-γlevel and IFN-γ/IL-4 ratio in CLL group were lower than those in control group（ P〈0. 05）; after treatment with PCR regimen,the IL-4,IL-17 and TGF-β levels as well as TGF-β/IL-17 ratio all significantly decreased（ P〈0. 05）,while IFN-γ level and IFN-γ/IL-4 ratio significantly increased（ P〈0. 05） as compared with those before treatment,moreover,the IL-4 and IL-17 levels as well as TGF-β/IL-17 and IFN-γ/IL-4 ratio were no significantly different from those in control group（ P〉0. 05）,only the IFN-γ and TGF-β levels were significantly diffrent from control group（ P〈0. 05）. The analysis of Binet staging（ stage A,B,C） showed that along with pregression of Binet stages,the TGF-γ/IL-17 levels as well as the IFN-γ/IL-4 ratio in CLL group negatively correlated with Binet staging（ r =-0. 53）,while the TGF-β/IL-17 ratio positively correlated with Binet staging（ r = 0. 46）. The analysis of grouping accoraing to therapentic efficacy fonnd that the IL-4 and IL-17 levels and IFN-γ/IL-4 and TGF-β/IL-17 ratios in CR and PR groups were significantly different before and after treatment（ P〈0. 05）,while those in SD and PD groups did not showed statistical difference before and after treatment（

关 键 词：慢性淋巴细胞白血病 干扰素-γ 白介素-4 白介素-17 血清转化生长因子-β 

分 类 号：R733.72[医药卫生—肿瘤]