细胞因子及淋巴细胞亚群在弥漫大B细胞淋巴瘤患者中的表达及临床意义  

Expression and Clinical Significance of Cytokines and Lymphocyte Subsets in Patients with Diffuse Large B-Cell Lymphoma

作　　者：谢宇 包红雨[1] 施小凤 王建宁[1] 韩雪[1] 孟庆齐[1] 蒋苏豫[1] 张露[1] 张柳波[1] 陈婉如 邹辛迪 XIE Yu;BAO Hong-Yu;SHI Xicao-Feng;WANG Jian-Ning;HAN Xue;MENG Qing-Qi;JIANG Su-Yu;ZHANG Lu;ZHANG Liu-Bo;CHEN Wan-Ru;ZOU Xin-Di(Department of Hematology,The Second ffiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China)

机构地区：[1]南京医科大学第二附属医院血液科,江苏南京210011

出　　处：《中国实验血液学杂志》2023年第4期1061-1068,共8页Journal of Experimental Hematology

基　　金：南京市科委课题(201803043);江苏省“六大人才高峰”第11批次高层次人才选拔培养资助项目(WSN-019)。

摘　　要：目的:探讨细胞因子和淋巴细胞亚群在弥漫大B细胞淋巴瘤(DLBCL)患者诊断、预后以及疗效评估中的作用,以及替雷利珠单抗对DLBCL患者免疫功能和细胞因子的影响。方法:选择本院23例初治DLBCL患者作为DLBCL组,同期34例巨幼细胞性贫血患者作为对照组,采用ELISA法检测患者外周血中细胞因子IL-2、IL-4、IL-6、IL-10、TNF-α、IFN-γ水平,采用流式细胞术检测淋巴细胞CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞、B淋巴细胞、NK细胞水平、CD4^(+)/CD8^(+)比值。比较不同临床特征、不同疗效的DLBCL患者外周血中细胞因子及淋巴细胞的水平。结果:DLBCL组患者外周血中细胞因子IL-2、IL-6、IL-10水平均明显高于对照组(P<0.05);细胞因子水平与患者年龄、性别无明显相关性(P>0.05);IPI评分越高、高Ann Arbor分期、有B症状、高β2-MG、高LDH及高CRP水平患者外周血中细胞因子IL-6及IL-10的水平均明显升高(P<0.05),高LDH水平患者IL-4水平也明显升高(P<0.05)。与治疗无效组相比,治疗有效组治疗前IL-6和IL-10水平明显降低,CD4^(+)T细胞和CD4^(+)/CD8^(+)比值明显升高(P<0.05);治疗有效组患者治疗后IL-6、IL-10和B淋巴细胞水平较治疗前显著下降(P<0.05),治疗无效组治疗前后细胞因子和淋巴细胞亚群均无明显变化(P>0.05)。经过4周期治疗后,替雷利珠组IL-2水平、CD4^(+)/CD8^(+)比值明显高于非替雷利珠组(P<0.05),CD8^(+)T细胞明显低于非替雷利珠组(P<0.05),替雷利珠组和非替雷利珠组治疗后的B淋巴细胞水平均较治疗前明显降低(P<0.05)。结论:DLBCL患者外周血中细胞因子水平升高和CD4^(+)T细胞数减少,且与疾病的严重程度、预后、治疗效果相关,替雷利珠单抗可通过影响DLBCL患者细胞因子和淋巴细胞亚群改善患者的免疫功能,加强抗肿瘤免疫。Objective:To study the role of cytokines and ly mphocyte subsets in the diagnosis,prognosis and efficacy evaluation of DI BCL patients,and the effects of Tislelizumab on immune function and cytokines in DLBCL patients.Methods:Twenty-three patients with newly diagnosed DLBCL were selected as DLBCL group and 34 patients with megaloblastic anemia as the control group.The levels of peripheral blood cytokines IL2,IL4,IL6,IL-10,TNF-a and IFN-γby ELISA method.The levels of peripheral blood CD3^(+),CD4^(+),CD8^(+)T lymphocytes,B lymphocytes and NK cells,the ratio of CD4^(+)/CD8^(+)were detected by flow cytometry.The levels of cytokins and lymphocyto subsets in DLBCL patients with different clinical data and different therapeutic effects were compared.Results:The levels of cytokines IL-2,IL-6 and IL-10 in DLBCL group were significantly higher than those in control group,but there was no significant correlation between cytokine levels and age and gender.The higher IPI score,higher Ann Arbor stage,B symptoms,higherβ2-MG,LDH and CRP levels,IL-6 and IL-10 levels were significantly higher,and IL4 was also significantly higher in patients with high LDH levels.Compared with the ineffective group,the levels of IL6 and IL-10 were significantly lower and the level of CD4^(+)T cells and the ratio of CD4/CD8^(+)was significantly higher in the effective group before therapy.The levels of IL6,IL-10 and B lymphocytes in the effective group decreased significantly after therapy compared to those before therapy.After 4 cycles of therapy,the level of IL2 and the ratio of CD4^(+)/CD8^(+)in the Tislelizumab group were significantly higher than those in the non-Tislelizumab group,and the level of CD8^(+)T cells was significantly lower than that in the non-Tislelizumab group(P<0.05).The level of B lymphocytes in both the Tislelizumab group and the non-Tislelizumab group after therapy was significantly lower than that before therapy.Conclusion:The expression of cytokines and ly mphocyte subsets in peripheral blood of patients with DLBCL is ab

关 键 词：细胞因子 淋巴细胞亚群 PD-1 弥漫大B细胞淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]