沙利度胺对弥漫大B细胞淋巴瘤疗效及Th17细胞和相关细胞因子表达的影响  

Effect of thalidomide on the efficacy of diffuse large B-cell lymphoma and the expressions of Th17 cells and related cytokines

作　　者：李丽[1] 杨一飞[2] 杨俊超[1] 周丽云[1] Li Li;Yang Yifei;Yang Junchao;Zhou Liyun(Department of Hematology, Affiliated Hospital of Hebei University of Engineering, Handan 056002, China （Li L, Yang JC, Zhou LY;Department of Discipline Construction and Graduate Education, Affiliated Hospital of Hebei University of Engineering, Handan 056002, China （Yang YF)

机构地区：[1]河北工程大学附属医院血液内科,邯郸056002 [2]河北工程大学附属医院学科建设与研究生教育办公室,邯郸056002

出　　处：《白血病．淋巴瘤》2018年第5期263-267,共5页Journal of Leukemia & Lymphoma

摘　　要：目的探讨沙利度胺对弥漫大B细胞淋巴瘤（DLBCL）患者外周血中Th17细胞、白细胞介素17（IL-17）、巨噬细胞炎性蛋白3α（MIP3α）表达及3年生存率的影响。方法选择2009年1月至2013年1月河北工程大学附属医院60例DLBCL患者，采用信封法随机分为联合组（30例，采用沙利度胺联合CHOP方案）和化疗组（30例，单用CHOP方案），比较两组临床疗效、不良反应、治疗前后外周血中Th17细胞、IL-17、MIP3α表达量以及3年生存率。 结果联合组和化疗组总有效率分别为73.3%（22/30）、46.7%（14/30），3年生存率分别为87.4%、40.7%，差异均有统计学意义（均P〈0.05）。治疗前后联合组外周血Th17细胞百分率及IL-17表达水平分别为（0.52±0.14）%和（1.61±0.53）%、（5.61±0.75）pg/ml和（8.87±1.84）pg/ml，差异均有统计学意义（均P〈0.05），而化疗组治疗前后Th17细胞及IL-17表达水平分别为（0.75±0.05）%和（0.74±0.07）%、（5.69±0.29）pg/ml和（5.26±0.24）pg/ml，差异均无统计学意义（均P〉0.05）。治疗前后联合组患者外周血清中IL-17、MIP3αmRNA表达水平分别为8.51±0.23和13.96±0.89、27.4±1.5和83.0±8.5，差异均有统计学意义（均P〈0.05），而化疗组治疗前后分别为8.85±0.32和9.45±0.55、23.7±1.8和38.7±5.5，差异均无统计学意义（均P〉0.05）。联合组与化疗组患者不良反应差异无统计学意义（P〉0.05）。 结论沙利度胺可能通过干预Th17细胞及相关细胞因子治疗DLBCL，延长DLBCL患者生存期。ObjectiveTo investigate the effect of thalidomide on the expressions of Th17 cells, interleukin 17 （IL-17）, macrophage inflammatory protein 3α （MIP3α） in peripheral blood of patients with diffuse large B-cell （DLBCL） and 3-year survival rate.MethodsSixty patients with DLBCL from January 2009 to January 2013 in the Affiliated Hospital of Hebei University of Engineering were enrolled. According to envelope method, the patients were randomly divided into the combined group （n = 30, thalidomide combined with CHOP regimen） and chemotherapy group （n = 30, CHOP regimen alone）. Clinical adverse reactions, efficacy, the expressions of Th17 cells, IL-17, MIP3α in peripheral blood before and after treatment, and 3-year survival rate between two groups were compared.ResultsThe total effective rate and 3-year survival rate were 73.3% （22/30） vs. 46.7% （14/30）, 87.4% vs. 40.7% respectively in the combined group and the chemotherapy group （both P 〈 0.05）. The levels of Th17 cells percentage and the expression level of IL-17 before and after treatment in combined group were （0.52±0.14）% vs. （1.61±0.53）%, （5.61±0.75） pg/ml vs. （8.87±1.84） pg/ml, and the difference was statistically significant （both P 〈 0.05）. However, the expression levels of Th17 cells and IL-17 before and after treatment in the chemotherapy group were （0.75±0.05）% vs. （0.74±0.07）%, （5.69±0.29） pg/ml vs. （5.26±0.24） pg/ml, and there was no statistical difference （both P 〉 0.05）. The levels of IL-17 and MIP3α mRNA in peripheral serum before and after treatment in the combined group were 8.51±0.23 vs.13.96±0.89, 27.4±1.5 vs. 83.0±8.5 （both P 〈 0.05）. While in the treatment group before and after treatment the above mentioned were 8.85±0.32 vs. 9.45±0.55, 23.7±1.8 vs. 38.7±5.5, and the difference was no statistically significant （both P 〉 0.05）. There was no statistical difference in the adverse reactions between the combined group and the chemotherapy gro

关 键 词：淋巴瘤 大B-细胞 弥漫性 药物疗法  联合 沙利度胺 TH17细胞 生存期 

分 类 号：R733.1[医药卫生—肿瘤]