多发性骨髓瘤患者外周血淋巴细胞亚群动态变化的临床意义  

Significance of dynamic variation of lymphocyte subsets in peripheral blood in patients with multiple myeloma

作　　者：余延芳[1] 高乃姝[2] 王明迪[1] 黄燕华[1] 吴道香 崔海佳 方志坚[1] YU Yan-fang;GAO Nai-shu;WANG Ming-di;HUANG Yan-hua;WU Dao-xiang;CUI Hai-jia;FANG Zhi-jian(Department of Hematology Medicine,Peking University Shougang Hospital,Beijing 100144,China;Department of Laboratory,Peking University Shougang Hospital,Beijing 100144,China)

机构地区：[1]北京大学首钢医院血液内科,北京100144 [2]北京大学首钢医院检验科,北京100144

出　　处：《中国肿瘤临床与康复》2021年第6期660-663,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨多发性骨髓瘤(MM)患者外周血淋巴细胞亚群动态变化的临床意义。方法选取2017年7月至2020年6月间北京大学首钢医院收治的54例初诊MM患者为研究组,每2个周期化疗后行疗效评估,分为有效组41例和无效组13例;另选取50例健康体检者为对照组。采用流式细胞仪检测两组受试者初诊、每2个周期化疗后外周血T淋巴细胞亚群、NK细胞和B细胞的动态变化。结果两组受试者外周血CD3^(+)细胞表达比较,差异无统计学意义(P>0.05)。MM组患者CD4^(+)细胞较对照组下降,CD8^(+)细胞升高,CD4^(+)/CD8^(+)降低,NK细胞增高,CD19^(+)细胞下降,差异均有统计学意义(均P<0.05)。与对照组比较,MM有效组患者外周血CD3^(+),差异无统计学意义(P>0.05);随着治疗疗程增加,CD4^(+)、CD8^(+)细胞和CD4^(+)/CD8^(+)比值逐渐恢复,CD19^(+)细胞增高,NK细胞下降。与对照组比较,MM无效组患者在治疗过程中一直存在CD4^(+)细胞表达下降,CD8^(+)细胞升高,CD4^(+)/CD8^(+)比值减低,NK细胞增高,CD19^(+)细胞下降,且以上表达均无改善趋势,差异有统计学意义(均P<0.05)。结论 MM患者存在免疫紊乱,动态监测外周血淋巴细胞亚群变化可预测疾病预后。Objective To explore the significance of dynamic variation of lymphocyte subsets in peripheral blood in patients with multiple myeloma. Methods Fifty-four patients newly diagnosed with multiple myeloma were selected at Peking University Shougang Hospital were selected and included in an experimental group from July 2017 to June 2020. The efficacy was assessed after every 2 cycles of chemotherapy,and 41 patients were included in an effective group and 13 patients were included in an ineffective group. Another 50 healthy individuals undergoing a medical examination were selected an included in a control group. Flow cytometry was used to detect dynamic variation of lymphocyte subsets including T cells,natural killer( NK) cells and B cells on diagnosis and after every 2 cycles of chemotherapy. Results There was no significant difference in the expression of CD3^(+)cells in peripheral blood between the two groups( P>0.05). CD4^(+),CD4^(+)/CD8^(+) and CD19^(+) levels decreased and CD8^(+) and NK cell levels increased in the experimental group compared with the control group( all P<0.05). There was no significant difference in the level of CD4^(+) between the two groups( P>0.05). With the increase in length of course,CD4^(+),CD8^(+)and CD4^(+)/CD8^(+) ratio recovered,the level of CD19^(+)still glides and the level of NK cell increased. Compared with the control group,CD4^(+) level decreased,CD8^(+) increased CD4^(+)/CD8^(+) ratio decreased,NK cell levels increased and CD19^(+) decreased in the ineffective group( all P<0.05). Conclusion The immune dysfunction may exist in patients with multiple myeloma,and detection of dynamic variation of lymphocyte subsets in peripheral blood may help to predict prognosis in patients with multiple myeloma.

关 键 词：淋巴细胞亚群 动态变化 多发性骨髓瘤 预后 

分 类 号：R739.42[医药卫生—肿瘤]