急性髓性白血病患者淋巴细胞中CD39^+CD4^+CD25^+T细胞比例与预后的相关性  

Correlation between the percentage of CD39^+CD4^+CD25^+T cells in lymphocytes and prognosis in patients with acute myeloid leukemia

作　　者：章梁君 钟辉秀 杨新春[1] ZHANG Liangjun;ZHONG Huixiu;YANG Xinchun(Department of Clinical Laboratory,Zigong First People's Hospital,Zigong 643000,Sichuan,China)

机构地区：[1]自贡市第一人民医院检验科,四川自贡643000

出　　处：《检验医学》2018年第12期1088-1093,共6页Laboratory Medicine

基　　金：自贡市重点科技计划项目(2015ZC10)

摘　　要：目的探讨急性髓性白血病(AML)患者淋巴细胞中CD39^+CD4^+CD25^+T细胞比例与预后的相关性。方法选取AML患者157例(AML组),并将其按AML 5种亚型分为AML-M1、AML-M2、AML-M3、AML-M4和AML-M55个亚组,以41名体检健康者作为正常对照组。采用流式细胞术检测所有对象外周血CD39^+CD4^+CD25^+T细胞和^+CD4^+CD25^+T细胞占淋巴细胞的比例。分别根据CD39^+CD4^+CD25^+T细胞或CD4^+CD25^+T细胞占淋巴细胞的比例将AML患者分为低、中、高水平组。结果 AML组及各亚组CD39^+CD4^+CD25^+T细胞比例均明显高于正常对照组(P<0.05)。AML组与正常对照组之间CD4^+CD25^+T细胞比例差异无统计学意义(P>0.05),但AML-M1组明显低于正常对照组(P<0.05)、AML-M2组明显高于正常对照组(P<0.05)。CD39^+CD4^+CD25^+T细胞低水平组、中水平组和高水平组髓外浸润比例及骨髓原始细胞CD34、CD7阳性率依次升高,各组间差异有统计学意义(P<0.05)。CD4^+CD25^+T细胞低水平组、中水平组和高水平组之间髓外浸润及CD34、CD7阳性率差异均无统计学意义(P>0.05)。与CD39^+CD4^+CD25^+T细胞低水平组比较,中水平组和高水平组的下次治疗时间(TTT)较短(P<0.05);而CD4^+CD25^+T细胞低水平组、中水平组和高水平组之间TTT差异无统计学意义(P>0.05)。结论 CD39^+CD4^+CD25^+T细胞比例升高与AML预后较差有关。CD39或可作为AML疾病发展的标志物。Objective To investigate the correlation between the percentage of CD39^+CD4^+CD25^+T cells in lymphocytes and prognosis in patients with acute myeloid leukemia(AML).Methods A total of157patients with AML(AML group)were enrolled and classified into5subtype groups(AML-M1,AML-M2,AML-M3,AML-M4and AML-M5),and41healthy subjects were enrolled as healthy control group.By flow cytometry,the percentages of CD39^+CD4^+CD25^+T cells and CD4^+CD25^+T cells in lymphocytes were determined.AML group was sub-classified into low-,middle-and high-level groups according to the percentage of CD39^+CD4^+CD25^+T cells or CD4^+CD25^+T cells in lymphocytes.Results Compared to healthy control group,the percentages of CD39^+CD4^+CD25^+T cells in lymphocytes were higher in AML group and its5subtype groups(P<0.05).There was no statistical significance for the percentages of CD4^+CD25^+T cells between AML and healthy control groups(P>0.05),but the percentage of AML-M1subtype group was lower than that in healthy control group(P<0.05),and the percentage of AML-M2subtype group was higher than that in healthy control group(P<0.05).The proportion of extramedullary infiltration and the positive rates of CD34and CD7of blast cells in low-,middleand-high-level groups according to the percentages of CD39^+CD4^+CD25^+T cells in lymphocytes were gradually increased(P<0.05),but there was no statistical significance among low-,middle-and high-level groups according to the percentages of CD4^+CD25^+T cells in lymphocytes(P>0.05).Patients with high-and middle-level CD39^+CD4^+CD25^+T cell percentages had a shorter time to next treatment(TTT)compared with patients with low-level CD39^+CD4^+CD25^+T cell percentage(P<0.05).However,patients with low-,middle-and highlevel CD4^+CD25^+T cell percentages had no statistical significance for TTT(P>0.05).Conclusions The increasing percentage of CD39^+CD4^+CD25^+T cells in lymphocytes is correlated with poor prognosis,and CD39may be a marker for the disease development of AML.

关 键 词：CD39^+CD4^+CD25^+T淋巴细胞 免疫抑制因子 免疫系统 急性髓性白血病 

分 类 号：R446.1[医药卫生—诊断学]