T淋巴细胞亚群与急性髓系白血病病理特征的关系及预测化疗预后的价值分析  

The Relationship between T Lymphocyte Subsets and Pathological Characteristics of Acute Myeloid Leukemia and the Value of Predicting Chemotherapy Prognosis

作　　者：刘春艳 常炳庆[1] 李超 任欣 刘小琴 LIU Chunyan;CHANG Bingqing;LI Chao;REN Xin;LIU Xiaoqin(Dept.of Hematology,Beijing Aerospace General Hospital,Beijing 100076;Dept.of Rheumatology and Immunology,Kaizhou District People's Hospital,Chongqing 405499,China)

机构地区：[1]北京航天总医院血液科,北京100076 [2]重庆市开州区人民医院血液风湿免疫科,重庆405499

出　　处：《昆明医科大学学报》2024年第5期116-122,共7页Journal of Kunming Medical University

基　　金：北京航天总医院创新基金资助项目(2020-605)。

摘　　要：目的分析外周血T淋巴细胞亚群水平与急性髓系白血病(acute myeloid leukemia,AML)患者病理特征的关系及对化疗预后的预测价值。方法选取2017年4月至2022年4月北京航天总医院80例AML患者作为研究组,另选同期性别、年龄匹配的80例健康志愿者作为对照组。比较2组一般资料、外周血T淋巴细胞亚群(CD4^(+)/CD8^(+)、CD3^(+)、CD4^(+))水平,比较研究组不同病理特征患者化疗前外周血T淋巴细胞亚群水平。并比较研究组不同预后患者临床资料、外周血T淋巴细胞亚群水平,分析AML预后不良的影响因素,分析外周血T淋巴细胞亚群预测AML预后不良的价值。结果与对照组比较,研究组化疗前外周血CD4^(+)/CD8^(+)、CD3^(+)、CD4^(+)水平明显降低(P<0.05);研究组NPM1突变阳性、FMS样酪氨酸激酶受体3-内部串联重复(FLT3-ITD)突变阳性、危险分层为低中风险患者外周血CD4^(+)/CD8^(+)、CD3^(+)、CD4^(+)水平分别高于NPM1突变阴性、FLT3-ITD阴性、危险分层为高风险患者(P<0.05);研究组预后不良患者年龄、危险分层高风险占比高于预后良好患者,化疗前外周血CD4^(+)/CD8^(+)、CD4^(+)、CD3^(+)水平低于预后良好患者(P<0.05);年龄、危险分层、化疗前外周血CD4^(+)/CD8^(+)、CD3^(+)、CD4^(+)水平均为AML患者预后不良的影响因素(P<0.05);化疗前外周血CD4^(+)/CD8^(+)、CD3^(+)、CD4^(+)预测AML预后不良的曲线下面积(area under curve,AUC)分别0.702、0.738、0.759。结论AML患者外周血CD4^(+)/CD8^(+)、CD3^(+)、CD4^(+)水平降低,与NPM1突变、FLT3-ITD突变、危险分层有关,且在预测AML预后不良方面具有一定预测价值。Objective To analyze the relationship between the level of peripheral blood T lymphocyte subsets and the pathological characteristics of patients with acute myeloid leukemia(AML),as well as its prognostic value for chemotherapy.Methods A total of 80 patients with AML in Beijing Aerospace General Hospital from April 2017 to April 2022 were selected as the study group,and 80 healthy volunteers matched for gender and age were selected as the control group.The general data and peripheral blood T lymphocyte subsets levels(CD4^(+)/CD8^(+),CD3^(+)and CD4^(+))of the two groups were compared,and the peripheral blood T lymphocyte subsets levels of patients with different pathological characteristics in the study group before the chemotherapy were compared.The clinical data and peripheral blood T lymphocyte subsets of patients with the different prognosis were compared in the study group,and the influencing factors of poor prognosis of AML were analyzed,and the value of peripheral blood T lymphocyte subsets in predicting poor prognosis of AML was analyzed.Results Compared with the control group,the levels of peripheral blood CD4^(+)/CD8^(+),CD3^(+)and CD4^(+)in the study group before the chemotherapy were significantly decreased(P<0.05);the levels of CD4^(+)/CD8^(+),CD3^(+)and CD4^(+)in peripheral blood of patients with positive NPM1 mutation,positive FLT3-ITD mutation,and low-risk stratification were higher than those of patients with negative NPM1 mutation,negative FLT3-ITD mutation,and high-risk stratification,respectively(P<0.05);The age and high-risk stratification of the poor prognosis patients in the research group were higher than those of the good prognosis patients,and the levels of CD4^(+)/CD8^(+),CD3^(+)and CD4^(+)in peripheral blood before chemotherapy were lower than those of the good prognosis patients(P<0.05);Age,risk stratification,CD4^(+)/CD8^(+),the CD3^(+)and CD4^(+)levels in peripheral blood before the chemotherapy were all factors influencing poor prognosis in AML patients(P<0.05);The areas under the c

关 键 词：急性髓系白血病 T淋巴细胞亚群 预后 预测 

分 类 号：R733.71[医药卫生—肿瘤]