急性髓系细胞白血病淋巴细胞亚群与预后的关系  

Relationship between lymphocyte subsets and prognosis in acute myeloid leukemia

作　　者：李翠 王卫国[1] 罗兵 冯梅 周楠楠 王伟伟[1] LI Cui;WANG Weiguo;LUO Bing;FENG Mei;ZHOU Nannan;WANG Weiwei(Clinical Laboratory,Fuyang people's Hospital,Fuyang 236001,China;Clinical Laboratory,the Second People's Hospital of Anhui,Hefe 230041,China)

机构地区：[1]阜阳市人民医院检验科,安徽阜阳236001 [2]安徽省第二人民医院检验科,合肥230041

出　　处：《长春中医药大学学报》2023年第6期678-682,共5页Journal of Changchun University of Chinese Medicine

基　　金：安徽省教育厅2019年度高校科学研究项目(KJ2019A1099)。

摘　　要：目的 探讨淋巴细胞亚群变化与急性髓系细胞白血病(AML)患者预后的关系及其临床意义。方法 收集AML患者101例,分为急性早幼粒细胞白血病(APL)组与AML-非APL组。APL组15例,AML-非APL组86例(细胞遗传学预后良19例、预后中等43例、预后不良24例)。健康体检者30例作为对照组。采用流式细胞术检测淋巴细胞亚群的相对计数和绝对计数。对AML-非APL患者进行随访,采用Kaplan-Meier法、COX比例风险回归模型分析NK细胞百分比与AML-非APL患者总生存时间(OS)的关系。结果 APL组CD3^(+)T细胞、CD8^(+)T细胞、CD4^(+)T细胞和CD19+B细胞计数低于AML-非APL组和对照组(P<0.05),NK细胞百分比高于AML-非APL组(P<0.05)。与对照组比较,APL组CD4+T细胞百分比、CD4/CD8和NK细胞计数降低(P<0.05),AML-非APL组AML1-ETO阴性患者NK细胞百分比降低(P<0.05)。AML-非APL组中细胞遗传学不良患者的NK细胞百分比低于预后良好组和预后中等组(P<0.05)。COX回归模型分析显示,低NK细胞百分比不是影响AML-非APL患者OS的独立预测因子。结论 不同亚型AML患者淋巴细胞亚群变化不一,NK细胞降低与不良细胞遗传学有关,但与AML-非APL患者OS无关。Objective To explore the relationship between the changes of lymphocyte subsets and the prognosis of patients with acute myeloid leukemia(AML)and its clinical significance.Methods 101 AML patients were selected as research objects and divided into acute promyelocytic leukemia(APL)group(n=15)and AML non-APL group(n=86).AML non-APL patients included 19 patients with good cytogenetic prognosis,43 patients with moderate prognosis and 24 patients with poor prognosis.30 Healthy individuals for physical examination were selected as the control group.The relative and absolute counts of lymphocyte subsets were tested by flow cytometry.AML non-APL patients were followed up.The relationship between the percentage of NK cells and the overall survival(OS)in AML non-APL patients was analyzed by using Kaplan-Meier method and COX proportional risk regression model.Results In APL group the counts of CD3^(+)T cells,CD8^(+)T cells,CD4^(+)T cells and CD19^(+)B cells were lower than those in AML non-APL group and the control group(P<0.05),and the percentage of NK cells was higher than that in AML non-APL group(P<0.05).Compared with the control group,the percentage of CD4+T cells,CD4/CD8 rate and NK cells counts were decreased in APL group(P<0.05),and the percentage of NK cells of AML1-ETO negative patients in AML non-APL group was decreased(P<0.05).The percentage of NK cells in patients with poor cytogenetic prognosis in AML non-APL group was lower than that in patients with good prognosis and moderate prognosis(P<0.05).COX risk regression model analysis showed that the lower percentage of NK cells was not independent predictor of OS in AML non-APL patients.Conclusion Different subtypes of AML patients have different lymphocyte subsets.The decrease of percentage of NK cells is related to poor cytogenetics,but that is not associated with OS in AML non-APL patients.

关 键 词：急性髓系细胞白血病 淋巴细胞 NK细胞 

分 类 号：R733.7[医药卫生—肿瘤]