外周血CD4^+CD25^(high) Treg比例变化对ALL预后判断的价值  

Role of peripheral blood CD4^+CD25^(high) Treg percentage in the prognosis of ALL

作　　者：赵莲 何金龙[1] 巫翠云[2] 周海燕[3] 周威伦 巫翠萍[1] ZHAO Lian;HE Jinlong;WU Cuiyun;ZHOU Haiyan;ZHOU Weilun;WU Cuiping(Department of Clinical Laboratory,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan,China;Department of Clinical Laboratory,Haikou People's Hospital,Haikou 570208,Hainan,China;Department of Oncology and Hematology,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan,China;Department of Pediatrics,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,Hainan,China)

机构地区：[1]海南医学院第一附属医院检验科,海南海口570102 [2]海口市人民医院检验科,海南海口570208 [3]海南医学院第一附属医院血液肿瘤内科,海南海口570102 [4]海南医学院第一附属医院儿科,海南海口570102

出　　处：《检验医学》2019年第4期327-330,共4页Laboratory Medicine

摘　　要：目的探讨急性淋巴细胞白血病(ALL)患者治疗前、后外周血CD4^+CD25^(high)调节性T细胞(Treg)比例的变化。方法采用流式细胞术检测22例ALL患者治疗前及用长春新碱+柔红霉素+环磷酰胺+泼尼松(VDCP)方案治疗后的外周血CD4^+CD25^(high)Treg比例。对所有患者随访5年,将13例持续完全缓解(CR)者作为CR组,将9例未缓解(NR)或缓解后5年内复发者作为NR组,以20名体检健康者作为正常对照组。结果与正常对照组比较,ALL组治疗前、后外周血CD4^+CD25^(high )Treg比例均升高(P<0.05),CR组治疗前外周血CD4^+CD25^(high)Treg比例明显升高(P<0.001),NR组治疗前则差异无统计学意义(P>0.05)。ALL组治疗后外周血CD4^+CD25^(high)Treg比例稍低于治疗前,但差异无统计学意义(P>0.05)。CR组治疗后外周血CD4^+CD25^(high)Treg比例明显低于治疗前(P<0.01),接近于正常对照组(P>0.05)。NR组治疗后外周血CD4^+CD25^(high)Treg比例明显高于治疗前(P<0.01),且明显高于正常对照组(P<0.001)。结论外周血CD4^+CD25^(high)Treg或许可作为ALL患者疗效监测的指标。Objective To investigate the percentage changes of peripheral blood CD4^+CD25^high regulatory T cells(Treg) in patients with acute lymphoblastic leukemia(ALL) before and after treatment. Methods Flow cytometry was used to determine CD4^+CD25^high Treg percentage in peripheral blood of 22 ALL patients before and after treatment [vincristine,daunorubicin,cyclophosphamide and prednisone(VDCP)]. After 5-year follow-up, 13 cases achieved complete remission(CR)(CR group),and 9 cases of non-remission(NR)(NR group) were enrolled. Totally,20 healthy subjects were enrolled as healthy control group. Results Compared with healthy control group,the percentage of CD4^+CD25^high Treg in peripheral blood increased before and after treatment in ALL group(P<0.05). The percentage of CD4^+CD25^high Treg in CR group was increased(P<0.001),while NR group had no statistical significance before treatment(P>0.05). The percentage of CD4^+CD25^high Treg after treatment was slightly lower in ALL group than that before treatment without statistical significance(P>0.05). The percentage of CD4^+CD25^high Treg after treatment was lower in CR group than that before treatment(P<0.01),and it was close to that in healthy control group(P>0.05). The percentage of CD4^+CD25^high Treg after treatment in NR group was higher than that before treatment(P<0.01),and it was higher than that in healthy control group(P<0.001). Conclusions CD4^+CD25^high Treg in peripheral blood may be used as an indicator for the treatment efficiency of ALL.

关 键 词：调节性T淋巴细胞 流式细胞术 急性淋巴细胞白血病 预后 

分 类 号：R446.1[医药卫生—诊断学]