儿童急性B淋巴细胞白血病外周血Treg和Th17细胞比值的平衡关系研究  

Ratio of Treg to Th17 cells in peripheral blood of children with B-cell acute lymphoblastic leukemia

作　　者：李晶晶 李静[1] 戴淑芝[1] 刘伟杰 马丽娟[1] Li Jingjing;Li Jing;Dai Shuzhi;Liu Weijie;Ma Lijuan(Department of Clinical Laboratory,Children′s Hospital Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院检验中心,北京100020

出　　处：《中华检验医学杂志》2021年第8期726-730,共5页Chinese Journal of Laboratory Medicine

基　　金：首都儿科研究所青年科研基金 (QN2017-13)。

摘　　要：目的探讨急性B淋巴细胞白血病(B-ALL)患儿外周血中CD4^(+)CD25^(+)Foxp3^(+)调节性T细胞(Treg)和辅助性T细胞17(Th17)的表达情况及其比值变化规律。方法选取2017年2月至2019年10月首都儿科研究所附属儿童医院初发急性B淋巴细胞白血病(B-ALL)患儿54例为研究对象,年龄4.9(3.1,7.4)岁。分为治疗前组和治疗后组,治疗后根据疾病转归分为完全缓解组45例,复发/难治组9例,选取20名查体儿童为对照组。运用流式细胞术(FCM)分别检测B-ALL患儿治疗前后和查体儿童外周血中CD4^(+)CD25^(+)Foxp3^(+)Treg细胞和Th17细胞占CD4^(+)T细胞的比例,并计算Treg/Th17细胞比值。在治疗前后分别比较复发/难治组、完全缓解组和对照组之间Treg、Th17细胞比例及Treg/Th17比值。分别比较完全缓解组和复发/难治组同一患儿治疗前后检测指标差异。结果B-ALL患儿治疗前,复发/难治组和完全缓解组外周血Treg细胞比例(分别为6.11±0.48,6.20±1.16)高于对照组(4.89±1.46),Treg/Th17细胞比值(分别为8.34±2.14,5.91±1.92)高于对照组(3.55±1.68),复发/难治组外周血Treg/Th17细胞比值高于完全缓解组,其差异均有统计学意义(P<0.05)。B-ALL患儿治疗后,复发/难治组外周血Treg细胞比例(6.09±0.80)高于完全缓解组(5.25±0.87)及对照组(4.89±1.46),Treg/Th17细胞比值(7.37±1.19)高于完全缓解组(4.22±1.50)及对照组(3.55±1.68),其差异均有统计学意义(P<0.05)。治疗后,完全缓解组患儿外周血Treg细胞比例及Treg/Th17细胞比值均低于治疗前,Th17细胞比例(1.38±0.49)高于治疗前(1.14±0.39),其差异均有统计学意义(P<0.05)。复发/难治组外周血Treg细胞及Treg/Th17细胞比率与治疗前比较,其差异均无统计学意义(P>0.05)。结论B-ALL患儿外周血存在CD4^(+)CD25^(+)Foxp3^(+)Treg细胞升高和Th17细胞比例降低所致的Treg/Th17细胞比值改变,随疾病的缓解而趋于正常。定期检测Treg细胞及Th17细胞比例有助于对B-ALLObjective To investigate the expression and ratio of CD4^(+)CD25^(+)Foxp3^(+)regulatory T cells(Tregs)to helper T cells 17(Th17)in the peripheral blood of children with B-cell acute lymphoblastic leukemia(B-ALL).Method 54 children with newly diagnosed B-ALL in Children′s Hospital Capital Institute of Pediatrics from February 2017 to October 2019 were selected as the research subjects,with a median age of 4.9(3.1 to 7.4)years.These children were divided into a pre-treatment group and a post-treatment group.According to the disease outcome after treatment,they were further divided into a complete remission group(45 cases),and a relapse/refractory group(9 cases).20 healthy children were selected as the control group.Flow cytometry(FCM)was used to detect the proportions of CD4^(+)CD25^(+)Foxp3^(+)Treg cells and Th17 cells.The ratio of Treg/Th17 cells was calculated.Result Before treatment,the proportion of Treg cells in the relapse/refractory group and the complete remission group(respectively 6.11±0.48,6.20±1.16)were higher than those in the control group(4.89±1.46)(P<0.05),and the ratio of Treg/Th17 cells in peripheral blood of children with B-ALL in relapse/refractory stage and complete remission stage(respectively 8.34±2.14,5.91±1.92)were higher than those in the control group(3.55±1.68)(P<0.05);The ratio of Treg/Th17 cells in the relapsed/refractory group was higher than that in the complete remission group(P<0.05).After treatment,the proportion of Treg cells and ratio of Treg/Th17 cells in peripheral blood of children with B-ALL in relapse/refractory stage(respectively 6.09±0.80,7.37±1.19)were higher than those in complete remission stage(respectively 5.25±0.87,4.22±1.50)and control group(respectively 4.89±1.46,3.55±1.68)(P<0.05).Compared with that before treatment,children in complete remission stage after treatment had lower proportions of Treg cells and the ratio of Treg/Th17 cells,as well as higher proportions of Th17 cells in the peripheral blood(P<0.05).There were no significant differences

关 键 词：急性B淋巴细胞白血病 儿童 流式细胞术 TH17细胞 TREG细胞 Treg/Th17比值 

分 类 号：R733.71[医药卫生—肿瘤]