髓系来源抑制细胞在多发性骨髓瘤患者中的外周血表达与临床效果观察  

Clinical observation of peripheral blood expression of MDSCs in patients with multiple myeloma

作　　者：刘永华[1] 江锦红[1] 朱亭郡 陈佳琪[3] 王朋[3] 兰义芬 周泽平 汪笑秋[1] 章俏雷[1] 王晓丽[1] 金伟媚 曾玉晓[1] 江妤 林煌 方炳木[1] Liu Yonghua;Jiang Jinhong;Zhu Tingjun;Chen Jiaqi;Wang Peng;Lan Yifen;Zhou Zeping;Wang Xiaoqiu;Zhang Qiaolei;Wang Xiaoli;Jin Weimei;Zeng Yuxiao;Jiang Yu;Lin Huang;Fang Bingmu(Department of Hematology of Lishui City people′s Hospital,Lishui 323000,China;Masster of Wenzhou Medical University,Wenzhou 325000,China;Department of Clinical Laboratory of Lishui City people′s Hospital,Lishui 323000,China)

机构地区：[1]丽水市人民医院血液科,浙江丽水323000 [2]温州医科大学2016级研究生血液病学专业,浙江温州325000 [3]丽水市人民医院检验科,浙江丽水323000

出　　处：《中国临床实用医学》2020年第1期2-5,共4页China Clinical Practical Medicine

基　　金：浙江省科技厅项目(2018C37097);浙江省中医药管理局项目(2016ZG036);丽水市科技局项目(2016RC23、2016sjzc49、2016zdxk03)。

摘　　要：目的探讨髓系来源抑制细胞(MDSCs)在多发性骨髓瘤(MM)患者中的外周血表达与临床效果。方法选取2015年10月至2017年6月丽水市人民医院血液科收治的40例初治型MM患者为MM组,男27例,女13例,年龄(58±8)岁,年龄范围为48~76岁。另外选取40例健康体检者作为健康对照组,其中男25例,女15例,年龄(56±11)岁,年龄范围为45~74岁。MM组患者入院后均采用一线治疗方案,通过流式细胞术检测外周血MDSCs、肿瘤相关巨噬细胞(TAM)及调节性T细胞(Tregs)表达,采用ELISA法检测患者外周血血清中的白细胞介素-6(IL-6)水平。结果治疗前MM组患者MDSCs[(8.40±2.15)%]、TAM[(6.33±1.34)%]、Tregs[(9.25±3.68)%]、IL-6[(13.40±0.80)pg/ml]均高于健康体检组[(0.47±0.26)%、(1.80±0.89)%、(2.42±3.31)%、(2.45±0.24)pg/ml],差异有统计学意义(P<0.05)。治疗后,MM组患者MDSCs[(0.94±0.41)%]、TAM[(2.64±1.12)%]、Tregs[(1.92±1.51)%]、IL-6[(5.62±0.56)pg/ml]显著低于治疗前,差异有统计学意义(P<0.05)。结论MDSCs在MM不同阶段呈规律性表达,与TAM、Tregs表达趋势一致,提示在MM发生、发展过程中MDSCs可能参与了骨髓瘤细胞的免疫耐受及肿瘤逃逸机制。Objective To investigate the expression and clinical effect of myeloid-derived suppressor cells(MDSCs)in peripheral blood of patients with multiple myeloma(MM).Methods From October 2015 to June 2017,40 newly treated MM patients in the Hematology Department of Lishui people′s hospital were selected as the MM group,27 males and 13 females,aged(58±8)years and ranging from 48 to 76 years.In addition,40 healthy people were selected as the control group,including 25 males and 15 females,aged(56±11)years,ranging from 45 to 74 years.In MM group,the first-line treatment was used after admission.The expression of MDSCs,TAM and Tregs were detected by flow cytometry.The level of IL-6 was detected by ELISA.Results Before treatment,MDSCs[(8.40±2.15)%],TAM[(6.33±1.34)%],Tregs[(9.25±3.68)%],IL-6[(13.40±0.80)pg/ml]in MM group were higher than those in healthy physical examination group[(0.47±0.26)%,(1.80±0.89)%,(2.42±3.31)%,(2.45±0.24)pg/ml],the difference was statistically significant(P<0.05).After treatment,MDSCs[(0.94±0.41)%],TAM[(2.64±1.12)%],Tregs[(1.92±1.51)%],IL-6[(5.62±0.56)pg/ml]in MM group were significantly lower than those before treatment(P<0.05).Conclusion MDSCs expressed regularly in different stages of MM,which was consistent with the expression trend of TAM and Tregs.

关 键 词：多发性骨髓瘤 髓系来源抑制细胞 调节性T细胞 肿瘤相关巨噬细胞 

分 类 号：R733[医药卫生—肿瘤]