【摘要】 目的研究自体外周血造血干细胞移植(auto-PBSCT)对弥漫性大B细胞淋巴瘤(DLBCL)患者程序性死亡因子-1(PD-1)及其配体B7同系物1(B7-H1)表达及T细胞亚群的影响。方法选择浙江大学医学院附属第一医院血液科和温州市中心医院血液科2009年7月至2012年6月接受auto-PBSCT的27例DLBCL患者作为观察组,选择25例同期参加体检的健康人群作为对照组。流式细胞仪检测两组PD-1、B7-H1表达,并分析各组T细胞亚群。结果观察组移植后3个月PD-1阳性表达率低于初次诊断时[(4.6±1.0)%和(12.5±2.1)%],差异具有统计学意义(t=4.47,P<0.05)。观察组两次检测结果均高于对照组,差异具有统计学意义(t=22.70和25.11,P均<0.05)。观察组移植后3个月B7-H1阳性表达率低于初次诊断时[(5.7±1.4)%和(16.3±1.7)%],差异具有统计学意义(t=6.78,P<0.05)。观察组两次B7-H1检测结果均高于对照组(t=25.15和38.06,P均<0.05)。观察组移植后3个月CD3+T细胞百分比高于初次诊断时[(57±7)%和(44±4)%],差异具有统计学意义(t=6.29,P<0.05)。观察组两次CD3+T细胞百分比检测结果均低于对照组(t=5.69和7.36,P均<0.05)。观察组移植后3个月CD4+T细胞百分比低于初次诊断时[(11±4)%和(29±3)%],差异具有统计学意义(t=5.47,P<0.05)。观察组两次CD4+T细胞百分比检测结果均低于对照组,差异具有统计学意义(t=4.61和7.11,P均<0.05)。观察组移植后3个月CD8+T细胞百分比高于初次诊断时[(32.5±2.7)%和(16.4±3.2)%],差异具有统计学意义(t=9.73,P<0.05)。与对照组相比,观察组初次诊断后CD8+T细胞百分比较低,而移植后3个月较高(t=10.62和14.71,P均<0.05)。观察组初次诊断后CD4+/CD8+比值高于移植后3个月(1.8±0.4和0.4±0.1),差异具有统计学意义(t=8.57,P<0.05)。移植后3个月CD4+/CD8+比值明显低于对照组,差异具有统计学意义(t=11.73,P<0.05)。结论 DLBCL患者存在细胞免疫功能紊乱,auto-PBSCT可以影响DLBCL患者的PD-1、B7-H1表达及T细胞亚群百分比,在一定程度上纠正细胞免疫功能。更多还原

【Abstract】 Objective To study the effect of autologous peripheral blood stem cell transplantation( auto-PBSCT) on programmed deathfactor-1( PD-1),B7-homolog1( B7-H1) expression and T cellsubsets in patients with diffuse large B cell lymphoma( DLBCL). Methods Observation group included 27 DLBCL patients underwent auto-PBSCT from July 2009 to June 2012,and 25 health people were selected as control. PD-1,B7-H1 in T cells and T cell subsets percentage were detected by flow cytometry in both group. Results The PD-1,B7-H1 expression in observation group were higher than control group( P < 0. 05). Compared with the primary DLBCL patients,the expression of PD-1 /B7-H1after auto-PBSCT significantly decreased( P < 0. 05). The percentage of CD3+,CD4+,CD8+T cells were( 44 ± 4) %,( 29 ± 3) %,( 16. 4 ± 3. 2) % in primary DLBCL patients,respectively,after transplantation they were( 57 ± 7) %,( 11 ± 4) %,( 32. 5 ± 2. 7) %,respectively,all the proportion in observation group were lower compared with control group [( 70 ± 5) %,( 52 ± 6) %,( 25. 9 ±2. 5) %,P < 0. 05]. Ratio of CD4+/CD8+in primary DLBCL patients was 1. 8 ± 0. 4,which was decreased after transplantation( 0. 4 ± 0. 1, P < 0. 05). Conclusions The cellular immune dysfunction was found in DLBCL patients and auto-PBST could increase the level of PD-1 and B7-H1,further more,influenced the T cell subsets.更多还原