检测外周血T淋巴细胞亚群、Th17和Treg细胞在初诊多发性骨髓瘤患者中的临床意义研究  

The clinical significance of detection of peripheral blood T lymphocyte subsets,Th17 and Treg cells in patients with early diagnosis of multiple myeloma

作　　者：程虹[1] 乔文斌[1] 黄艳春[1] CHENG Hong;QIAO Wenbin;HUANG Yanchun(Clinical Laboratory,Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi,Xijiang 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院检验科,乌鲁木齐830011

出　　处：《国际检验医学杂志》2017年第24期3401-3403,3407,共4页International Journal of Laboratory Medicine

基　　金：新疆医科大学创新基金项目(XYDCX201543)

摘　　要：目的探讨初诊多发性骨髓瘤(MM)患者外周血中T淋巴细胞亚群表达特点,以及辅助性T细胞17(Thl7)和CD4^+CD25^+Foxp3^+调节性T细胞(Treg细胞)比率的平衡关系,分析其在MM发病中的临床意义。方法检测30例初诊的MM患者(病例组)及20例健康志愿者(对照组)外周血中总T细胞(CD3^+)、辅助性T细胞/诱导T细胞(CD3^+CD4^+)、抑制性T细胞/细胞毒性T细胞(CD3^+CD8^+)、(CD3^+CD4^+)/(CD3^+CD8^+)的比值;以及Thl7和Treg细胞各占的比率、Th17细胞/Treg比值,比较分析MM患者与对照组的差异。结果与对照组相比,病例组患者的抑制性T细胞/细胞毒性T细胞(CD3^+CD8^+)比例较对照组升高,差异有统计学意义(P<0.05);病例组患者的(CD3^+CD4^+)/(CD3^+CD8^+)比值较对照组降低,差异有统计学意义(P<0.05);病例组患者外周血Th17细胞的比率为(5.9±1.9)%,与对照组(4.0±0.9)%相比增高,差异有统计学意义(P<0.05);病例组Treg细胞比率为(1.2±0.3)%,与对照组(2.1±0.4)%相比,比值降低,差异有统计学意义(P<0.05);病例组Th17/Treg细胞比值较对照组明显增高,差异有统计学意义(P<0.05)。结论 MM患者体内存在外周血T细胞亚群的紊乱,Thl7细胞比率升高和Treg细胞比率降低所致的Thl7/Treg细胞比例失衡,该免疫失衡可能在MM的发生、发展中发挥一定作用,并对预后的判断有一定的指导价值。Objective To investigate the expression characteristics of T lymphocyte subsets in peripheral blood of patients with newly diagnosed multiple myeloma(MM),as well as the equilibrium relationship between the ratio of helper T cells17(Thl7)and CD4+CD25+Foxp3+regulatory T cells(Treg cells),and analyze their clinical significance in the pathogenesis of MM.Methods The proportion of CD3+,CD3+CD4+,CD3+CD8+cells,Th17cells,Treg cells in peripheral blood and the ratios of CD3+CD4+/CD3+CD8+、Th17/Treg were analyzed between the30patients with MM in newly diagnosed and20healthy volunteers(control group),then analysis the differences between MM patients and control group.In30cases of newly diagnosed MM patients(patient group)and20healthy volunteers(control group),total T cells in peripheral blood(CD3+),auxiliary T cells/induced T cells(CD3+CD4+),the inhibitory T cell/cytotoxic T cells(CD3+CD8+),the ratio of(CD3+CD4)/(CD3+CD8+),the percentages of Th17cells and Treg cell and the ratio of Thl7and Treg were detected,and the differences between MM patients and control group were compared.Results The ratio of inhibition/cytotoxic T cells(CD3+CD8+)in the patient group was higher than that in the control group(P<0.05).(CD3+CD4+)/(CD3+CD8+)ratio in the patient group was lower than that in the control group(P<0.05);in the patient group,the ratio of Th17cells in peripheral blood of patients was(5.9±1.9)%,which was increased compared with the control group(4.0±0.9)%(P<0.05);the ratio of Treg cells in the patient group was(1.2±0.3)%,which was decreased compared with the control group(2.1±0.4%)(P<0.05);and the ratio of Th17/Treg cells was significantly higher in the patient group,and the difference was statistically significant(P<0.05).Conclusion Peripheral blood T cell subsets disorder exists in patients with MM,Thl7/Treg cell imbalance caused by the increase of Thl7cell ratio and the decrease of the ratio of Treg cells,and the imbalance of immune system may play a role in the occurrence and development of MM,and has some guiding value

关 键 词：多发性骨髓瘤 T淋巴细胞亚群 THL7细胞 TREG细胞 Thl7/Treg细胞比例 

分 类 号：R730.43[医药卫生—肿瘤] R733.3[医药卫生—临床医学]