急性髓系白血病患者外周血辅助性T细胞17和白细胞介素17A水平及其临床意义  

Levels of peripheral blood helper T cell 17 and interleukin-17A in acute myeloid leukemia and its clinical significance

作　　者：王志敏[1] 潘学霞[2] 李尊昌[1] 王立盼[1] Wang Zhimin;Pan Xuexia;Li Zunchang;Wang Lipan(Department of Hematology,Binzhou People's Hospital of Shandong Province,Binzhou 256610,China;Department of Pediatric,Binzhou People's Hospital of Shandong Province,Binzhou 256610,China)

机构地区：[1]山东省滨州市人民医院血液内科,256610 [2]山东省滨州市人民医院儿科,256610

出　　处：《白血病．淋巴瘤》2020年第10期595-598,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探讨急性髓系白血病(AML)初诊患者外周血辅助性T细胞17(Th17)和白细胞介素17A(IL-17A)的水平及意义。方法选择2017年9月至2019年1月在山东省滨州市人民医院就诊的32例初诊AML患者(研究组),选取同期住院的缺铁性贫血患者28例作为对照组。采用流式细胞术检测两组患者外周血中Th17(CD3+CD4+IL-17+)占CD4+T细胞比例(简称Th17比例)及IL-17A浓度,分析二者与AML患者初诊时骨髓原始细胞比例、染色体核型等指标的相关性及意义。结果初诊AML患者外周血中Th17比例为(2.74±0.85)%,高于对照组的(1.02±0.12)%,差异有统计学意义(t=10.397,P<0.01);AML组患者血清中IL-17A浓度为(3.16±1.54)pg/ml,低于对照组的(2.22±0.21)pg/ml,差异有统计学意义(t=3.206,P=0.002)。骨髓原始细胞比例≥0.50的AML患者外周血中Th17比例及IL-17A浓度高于骨髓原始细胞比例<0.50的患者。细胞遗传学/分子遗传学高危组AML患者外周血Th17比例和IL-17A浓度均高于低危组,差异均有统计学意义(均P<0.05),低危组和中危组间两者差异均无统计学意义(均P>0.05)。结论AML患者外周血Th17、IL-17A水平与骨髓原始细胞比例及细胞遗传学/分子遗传学危险度有关,定期检测Th17和IL-17A有助于对患者进行免疫状态监测以及预后判断,并为AML的免疫治疗提供依据。Objective To study the expression levels of peripheral blood helper T cell 17 (Th17) cells and interleukin (IL)-17A in newly diagnosed acute myeloid leukemia (AML) patients and its significance.Methods A total of 32 newly diagnosed AML patients in Binzhou People's Hospital of Shandong Province from September 2017 to January 2019 were treated as the study group, and 28 iron deficiency anemia patients were used as the control group. Flow cytometry (FCM) was used to detect the proportion of Th17 (CD3+ CD4+ IL-17+) in CD4+ T cells (Th17 ratio) and the concentration of IL-17A in peripheral bloods for both groups. And then the correlation and significance of Th17 ratio and the concentration of IL-17A with proportion of bone marrow blast cells, chromosome karyotype in AML patients was also analyzed.Results The proportion of Th17 cells in peripheral bloods of newly diagnosed AML patients was higher than that in the control group [(2.74±0.85)% vs. (1.02±0.12)%, t = 10.397, P < 0.01];the concentration of IL-17A in the serums of AML patients was higher than that of the control group [(3.16±1.54) pg/ml vs. (2.22±0.21) pg/ml, t = 3.206, P = 0.002]. Th17 ratio and the concentration of IL-17A in patients with bone marrow blast cells percentage≥0.50 were higher than those in patients with bone marrow blast cells percentage <0.50. Th17 ratio and the concentration of IL-17A in the peripheral bloods for AML patients in the high-risk group was higher than that in the low-risk group, and the difference was statistically significant (both P < 0.05). There was no statistical difference between low-risk group and intermediate-group (both P > 0.05).Conclusions The levels of Th17 cells and IL-17A in the peripheral bloods are associated with the proportion of bone marrow blast cells and cytogenetics/molecular genetics risk degree in AML patients. The regular detection of Th17 and IL-17A may help to monitor immune status, evaluate prognosis and provide the basis for immunotherapy of AML patients.

关 键 词：白血病 髓样 急性 辅助性T细胞17 白细胞介素17A 流式细胞术 

分 类 号：R733.71[医药卫生—肿瘤]