免疫细胞亚群与多发性骨髓瘤临床预后因子相关性研究  

The correlation between immune cell subsets and clinical prognostic factors of multiple myeloma

作　　者：魏文波[1] 杜宇 WEI Wen-bo;DU Yu(Clinical Laboratory,Leshan Hospital of Armed Police Sichuan Corps,Leshan 614000,China)

机构地区：[1]乐山市武警四川总队医院检验科,四川乐山614000

出　　处：《实用医院临床杂志》2019年第2期37-40,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨免疫细胞亚群与多发性骨髓瘤临床预后因子相关性。方法我院收治的32例多发性骨髓瘤患者,根据年龄不同分为45～60岁组(18例)和60岁以上组(14例),选取同年龄段的健康者作为对照,分别为62例和42例。各组采用流式细胞仪进行淋巴细胞亚群免疫表型检测,采用荧光原位杂交技术进行细胞遗传学危险度分层,采用免疫比浊法检测β2-MG水平。结果与对照组比较,不同年龄段的两组患者CD8^+HLADR^+/CD8^+百分比、CD8^+CD38^+/CD8^+百分比明显升高(P <0. 05),CD4^+CD28^+/CD4^+百分比明显降低(P <0. 05);细胞遗传学(FISH)高危组CD8^+T淋巴细胞、CD8^+HLADR^+/CD8^+细胞占比高于FISH无高危组,CD4^+CD28^+/CD4^+细胞占比低于FISH无高危组(P <0. 05); CD8^+细胞百分比、CD8^+HLADR^+/CD8^+百分比与血清β2-MG水平呈正相关,CD4^+CD28^+/CD4^+百分比与β2-MG呈负相关(P <0. 05)。结论多发性骨髓瘤外周血CD4^+T细胞功能缺陷,CD8^+T淋巴细胞异常增生以及CD8^+T细胞功能异常活化与细胞遗传学危险度分层及预后存在一定的相关性,这可能成为疾病预后的判断指标,值得临床深入研究。Objective To investigate the correlation between immune cell subsets and clinical prognostic factors of multiple myeloma.Methods Thirty-two patients with multiple myeloma admitted to our hospital were divided into 45-60 years old group(n=18)and>60 years old group(n=14)according to the age of patients.At the same period,age-matched healthy subjects were taken as controls(n=62 and n=42 for the different age groups,respectively).Flow cytometry was used to detect the lymphocyte subsets.Fluorescence in situ hybridization(FISH)was used to stratify the risk of cytogenetics.Immunoturbidimetric assay was used to detect p2-MG level.Results Compared with the control group,percentages of CD8^+HLADR^+/CD8^+and CD8^+CD38^+/CD8^+were significantly increased while percentage of CD4^+CD28^+/CD4^+was significantly decreased in both age groups of the patients(P<0.05).The results of FISH showed that CD8^+T lymphocytes and CD8^+HLADR^+/CD8^+was significantly higher while CD4^+CD28^+/CD4^+cells were significant lower in cytogenetic high-risk group than those in non high-risk group(P<0.05).Percentages of CD8^+cells and CD8^+HLADR^+/CD8^+cells were positively correlated with serumβ2-MG level(P<0.05)while percentage of CD4^+CD28^+/CD4^+cells was negatively correlated withβ2-MG lev el(P<0.05).Conclusion In peripheral blood of multiple myeloma,defection of CD4^+T cell function,abnormal proliferation of CD8^+T lymphocyte and dysfunctional activation of CD8^+T cells have a certain correlation with cytogenetic risk stratification and prognosis.These may become the judging indicators for disease prognosis.It is worthy of in-depth clinical research.

关 键 词：免疫功能缺陷 临床预后因素 多发性骨髓瘤 发病机制 临床探究 

分 类 号：R446.63[医药卫生—诊断学]