NK细胞联合Treg细胞对慢性粒细胞白血病患者酪氨酸激酶抑制剂停药的预测价值  

The predictive value of NK cells combined with Treg cells for TKI discontinuation in patients with chronic myeloid leukemia

作　　者：陈曦[1] 王欢[1] 李小龙 沈丽[1] 刘洪涛[1] 王碧薇 赵宏微 CHEN Xi;WANG Huan;LI Xiaolong;SHEN Li;LIU Hongtao;WANG Biwei;ZHAO Hongwei(Department of Hematology,Tangshan Workers Hospital,Tangshan 063000,Hebei,China;不详)

机构地区：[1]唐山市工人医院血液科,河北唐山063000 [2]华北理工大学理学院,河北唐山063210

出　　处：《实用医学杂志》2024年第20期2900-2904,共5页The Journal of Practical Medicine

基　　金：河北省医学科学研究课题计划(编号:20240538)。

摘　　要：目的探讨NK细胞及Treg细胞在慢性粒细胞白血病(chronic myeloid leukemia,CML)应用酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)停药患者中的变化及二者对TKI停药的预测价值。方法随机选取确诊为CML的患者200例,分为停药组(n=100)和未停药组(n=100),停药组患者进一步分为复发组(n=41)和未复发组(n=59),对患者的临床资料及随访资料进行回顾性分析。Logistic回归分析各变量对停药后结局的影响,探讨患者停药后复发的独立影响因素。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析NK细胞及Treg对TKI停药后结局的预测价值。结果停药组中应用干扰素治疗的患者比例显著高于未停药组(P<0.05),而前者NK细胞(P<0.05)及Treg细胞(P<0.01)的数量显著高于后者。与复发组患者相比,未复发组患者中应用干扰素的比例显著高于前者(P<0.05),TKI治疗时间及深度分子学反应(deep molecular response,DMR)持续时间均显著大于复发组患者(P<0.05)。未复发组的NK细胞及Treg细胞的数量显著高于复发组(P<0.01)。Logistic回归分析发现,是否应用干扰素(OR=1.25,95%CI:1.11~2.03,P<0.001)、DMR持续时间(OR=1.16,95%CI:1.08~1.92,P<0.05)、NK细胞(OR=1.64,95%CI:1.14~2.28,P<0.01)、Treg细胞(OR=1.83,95%CI:1.15~2.42,P<0.01)均是停药后患者是否复发的关键影响因素。ROC曲线分析结果表明,NK细胞联合Treg细胞预测TKI停药后是否复发的AUC=0.892(95%CI:0.857~0.927,P<0.001)。结论NK细胞和Treg细胞在TKI停药未复发的患者中显著增加,二者联合对于CML患者停药是否复发具有良好的预测作用。Objective To investigate the dynamics of NK cells and Treg cells,as well as their potential prognostic significance in relation to TKI discontinuation among patients diagnosed with chronic myeloid leukemia(CML).Methods In this study,a total of 200 patients diagnosed with CML were randomly selected and divided into two groups:the discontinuation group(n=100)and the non-discontinuation group(n=100).Within the discontinuation group,patients were further categorized into a recurrence subgroup(n=41)and a non-recurrence subgroup(n=59).Clinical data and follow-up information of these patients were retrospectively analyzed.Logistic regression analysis was performed to investigate the impact of various variables on patient outcomes following drug discontinuation,as well as to explore independent factors influencing recurrence in these individuals.Receiver operating characteristic(ROC)curve analysis was employed to assess the predictive value of NK cells and Treg cells for TKI discontinuation outcomes.A significance level of P<0.05 was considered statistically significant.Results The proportion of patients treated with interferon in the discontinuation group was significantly higher than that in the non-discontinuation group(P<0.05).Moreover,the former group exhibited a significantly higher number of NK cells(P<0.05)and Treg cells(P<0.01)compared to the latter group.Compared to the recurrence group,there was a significant increase in the proportion of patients using interferon in the non-recurrence group(P<0.05),along with longer durations of TKI treatment and deep molecular response(DMR)duration(P<0.05).The number of NK cells and Treg cells in the non-recurrence group was significantly higher than that in the recurrence group(P<0.01).Logistic regression analysis found that the use of interferon(OR=1.25,95%CI:1.11~2.03,P<0.001),duration of DMR(OR=1.16,95%CI:1.08~1.92,P<0.05),NK cells(OR=1.64,95%CI:1.14~2.28,P<0.01),and Treg cells(OR=1.83,95%CI:1.15~2.42,P<0.01)were all influencing factors for the recurrence of patients aft

关 键 词：NK细胞 TREG细胞 慢性粒细胞白血病 TKI停药 预测价值 

分 类 号：R557[医药卫生—血液循环系统疾病]