CD4^(+)CD25^(+)FOXP3^(+)Treg细胞在高危多发性骨髓瘤治疗中预测复发及治疗意义  

Significance of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in predicting recurrence and therapeutic effect in treatment of high-risk multiple myeloma

作　　者：王晓丽[1] 江妤 曾玉晓[1] 刘永华[1] 章俏雷[1] WANG Xiaoli;JIANG Yu;ZENG Yuxiao;LIU Yonghua;ZHANG Qiaolei(Department of Hematology,Lishui People′s Hospital in Zhejiang Province,Lishui 323000,China)

机构地区：[1]浙江省丽水市人民医院血液科,浙江丽水323000

出　　处：《中国现代医生》2021年第16期32-36,共5页China Modern Doctor

基　　金：浙江省医学会临床科研基金项目(2019ZYCA191);浙江省基础公益研究计划项目(LGF19H080003);浙江省丽水市科技计划项目(2020GYX24)。

摘　　要：目的探讨CD4^(+)CD25^(+)FOXP3^(+)调节性T淋巴细胞(Treg)在高危多发性骨髓瘤治疗中预测复发及治疗意义。方法选择2018年3月至2019年3月我院收治的126例高危多发性骨髓瘤患者为病例组,同期在我院体检健康者100例为对照组,比较病例组和对照组不同化疗疗效、不同复发情况患者外周血CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例,用Spearman相关性分析CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例与患者复发的相关性,用受试者工作特征曲线(ROC)分析CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例预测患者复发的价值,并进行CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例不同患者随访期间无进展生存的Kaplan-Meier分析。结果病例组CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例远高于对照组(P<0.001);化疗无效患者CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例远高于化疗有效患者(P<0.001);复发患者CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例远高于未复发患者(P<0.001);CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例与患者复发呈正相关(P<0.05);CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例预测患者复发的AUC(95%CI:0.759~0.856)为0.809,敏感性为62.80%,特异性为95.80%,准确性为89.30%,截断值为3.66%。CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例>3.66%组随访期间无进展生存率显著低于CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例<3.66%组(P<0.05)。结论CD4^(+)CD25^(+)FOXP3^(+)Treg细胞比例在高危多发性骨髓瘤患者外周血中呈上升状态,其水平检测对于化疗后复发有一定预测价值,有助于临床预测化疗效果、监测早期复发及预后判断。Objective To explore the significance of CD4^(+)CD25^(+)FOXP3^(+) regulatory T lymphocytes(Treg)in predicting recurrence and therapeutic effect in the treatment of high-risk multiple myeloma.Methods A total of 126 patients with high-risk multiple myeloma admitted to our hospital from March 2018 to March 2019 were selected as the case group,and 100 healthy patients who received physical examination in our hospital during the same period were selected as the control group.The proportions of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in the peripheral blood were compared between the case group and the control group,and among patients with different chemotherapy effect and recurrence conditions.Spearman correlation was used to analyze the correlation between the proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells and the recurrence.Receiver operating characteristic curve(ROC)was used to analyze the value of the proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in predicting recurrence.Kaplan-Meier analysis was used to analyze the progression-free survival during follow-up of patients with different proportions of CD4^(+)CD25^(+)FOXP3^(+) Treg cells.Results The proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in the case group was significantly higher than that in the control group(P<0.001).The proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in chemotherapy-ineffective patients was significantly higher than that in chemotherapy-effective patients(P<0.001).The proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in patients with recurrence was significantly higher than that of patients without recurrence(P<0.001).The proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells was positively correlated with patient recurrence(P<0.05).The AUC of the proportion of CD4^(+)CD25^(+)FOXP3^(+) Treg cells in predicting recurrence was 0.809(95%CI:0.759-0.856),with sensitivity of 62.80%,specificity of 95.80%,accuracy of 89.30%,and cutoff value of 3.66%.The patients with CD4^(+)CD25^(+)FOXP3^(+) Treg cell ratio>3.66%had a significantly lower progres

关 键 词：CD4^(+)CD25^(+)FOXP3^(+) 调节性T淋巴细胞 高危 多发性骨髓瘤 化疗 疗效 复发 

分 类 号：R733.3[医药卫生—肿瘤]