多发性骨髓瘤患者外周血Treg和Th17的水平检测及其临床价值  

Detection of Treg and Th17 level in peripheral blood of multiple myeloma and its clinical value

作　　者：冯睿婷 宋银森 赵继智[1] 秦娜[1] 门颖丽 FENG Ruiting;SONG Yinsen;ZHAO Jizhi;QIN Na;MEN Yingli(The Research Center for Translational Medicine,Zhengzhou People's Hospital,Henan Zhengzhou 450003,China)

机构地区：[1]郑州人民医院转化医学研究中心,河南郑州450003

出　　处：《现代肿瘤医学》2025年第1期90-95,共6页Journal of Modern Oncology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20220779,LHGJ20210707);河南省郑州市医疗卫生领域科技创新指导计划项目(编号:2024YLZDJH273)。

摘　　要：目的:检测多发性骨髓瘤患者外周血Treg和Th17水平并研究其临床价值。方法:选择多发性骨髓瘤患者(MM组)及正常健康人(CON)为研究对象,流式细胞仪检测外周血Treg和Th17水平,采用实时荧光定量PCR(RT-qPCR)检测Foxp3及RORγt水平,比较不同临床病理特征中Treg、Th17、Foxp3及RORγt的差异。采用ROC曲线分析Treg联合Th17预测多发性骨髓瘤患者1年预后不良的敏感度和特异度。多因素Cox回归分析多发性骨髓瘤患者死亡的危险因素。结果:MM组患者Treg、Th17、Foxp3及RORγt均高于CON组,差异有统计学意义(P<0.05)。ISS分期III期、r-ISS分期III期、MRD^(+)多发性骨髓瘤患者Treg、Th17、Foxp3及RORγt均显著高于ISS分期I期-II期、r-ISS分期I期-II期、MRD-多发性骨髓瘤患者(P<0.05)。Treg联合Th17预测多发性骨髓瘤1年预后不良敏感度、特异度及AUC均高于Treg、Th17、Foxp3、RORγt、ISS分期、r-ISS分期、微小病灶残留(P<0.05)。Treg≥8.23%、Th17≥3.05%、Foxp3≥1.12、RORγt≥0.94、ISS分期III期、r-ISS分期III期、微小病灶残留MRD^(+)为多发性骨髓瘤患者死亡的独立危险因素(P<0.05)。结论:多发性骨髓瘤患者外周血Treg及Th17表达显著升高,与病情及预后密切相关,可作为多发性骨髓瘤病情及预后评估的标志物,两者联合检测时可显著提高预测多发性骨髓瘤预后不良的敏感度及特异度。Objective:To detect Treg and Th17 in peripheral blood of patients with multiple myeloma and study their clinical value.Methods:Multiple myeloma patients(MM group)and normal healthy people(CON)were selected as research subjects.Peripheral blood Treg and Th17 were detected by flow cytometry,and Foxp3 and RORγt were detected by real-time fluorescence quantitative PCR(RT-qPCR).Compare the differences in Treg,Th17,Foxp3 and RORγt in different clinicopathological characteristics.The ROC curve was used to analyze the sensitivity and specificity of Treg combined with Th17 in predicting poor 1-year prognosis in multiple myeloma.Multivariate Cox regression analysis of risk factors for death in multiple myeloma.Results:Treg,Th17,Foxp3 and RORγt in the MM group were higher than those in the CON normal healthy people,and the difference was statistically significant(P<0.05).Treg,Th17,Foxp3 and RORγt in ISS stage III,r-ISS stage III,MRD^(+)multiple myeloma patients were significantly higher than those in ISS stage I to II,r-ISS stage I to II,and MRD-patients with multiple myeloma(P<0.05).The sensitivity,specificity and AUC of Treg combined with Th17 in predicting poor 1-year prognosis of multiple myeloma were higher than those of Treg,Th17,Foxp3,RORγt,ISS stage,r-ISS stage,and minimal residual disease(P<0.05).Treg≥8.23%,Th17≥3.05%,Foxp3≥1.12,RORγt≥0.94,ISS stage III,r-ISS stage III,minimal residual disease MRD^(+)are independent risk factors for death in patients with multiple myeloma(P<0.05).Conclusion:Treg and Th17 are significantly increased in patients with multiple myeloma,which are closely related to the condition and prognosis.They can be used as markers for the assessment of the condition and prognosis of multiple myeloma.The combined detection of the two can significantly improve the prediction sensitivity and specificity of multiple myeloma.

关 键 词：多发性骨髓瘤 TREG TH17 FOXP3 RORΓT 临床价值 

分 类 号：R738.1[医药卫生—肿瘤]