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外周血CD4⁺CD25^high Treg比例变化对ALL预后判断的价值

Role of peripheral blood CD4⁺CD25^high Treg percentage in the prognosis of ALL

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【Author】 ZHAO Lian;HE Jinlong;WU Cuiyun;ZHOU Haiyan;ZHOU Weilun;WU Cuiping;Department of Clinical Laboratory,the First Affiliated Hospital of Hainan Medical College;Department of Clinical Laboratory,Haikou People’s Hospital;Department of Oncology and Hematology,the First Affiliated Hospital of Hainan Medical College;Department of Pediatrics,the First Affiliated Hospital of Hainan Medical College;

【通讯作者】巫翠萍;

【机构】海南医学院第一附属医院检验科；海口市人民医院检验科；海南医学院第一附属医院血液肿瘤内科；海南医学院第一附属医院儿科；

【摘要】目的探讨急性淋巴细胞白血病（ALL）患者治疗前、后外周血CD4⁺CD25^high调节性T细胞（Treg）比例的变化。方法采用流式细胞术检测22例ALL患者治疗前及用长春新碱+柔红霉素+环磷酰胺+泼尼松（VDCP）方案治疗后的外周血CD4⁺CD25^highTreg比例。对所有患者随访5年,将13例持续完全缓解（CR）者作为CR组,将9例未缓解（NR）或缓解后5年内复发者作为NR组,以20名体检健康者作为正常对照组。结果与正常对照组比较,ALL组治疗前、后外周血CD4⁺CD25^highTreg比例均升高（P<0.05）,CR组治疗前外周血CD4⁺CD25^highTreg比例明显升高（P<0.001）,NR组治疗前则差异无统计学意义（P>0.05）。ALL组治疗后外周血CD4⁺CD25^highTreg比例稍低于治疗前,但差异无统计学意义（P>0.05）。CR组治疗后外周血CD4⁺CD25^highTreg比例明显低于治疗前（P<0.01）,接近于正常对照组（P>0.05）。NR组治疗后外周血CD4⁺CD25^highTreg比例明显高于治疗前（P<0.01）,且明显高于正常对照组（P<0.001）。结论外周血CD4⁺CD25^highTreg或许可作为ALL患者疗效监测的指标。更多还原

【Abstract】 Objective To investigate the percentage changes of peripheral blood CD4⁺CD25^high regulatory T cells（Treg）in patients with acute lymphoblastic leukemia（ALL）before and after treatment.Methods Flow cytometry was used to determine CD4⁺CD25^high Treg percentage in peripheral blood of 22 ALL patients before and after treatment[vincristine,daunorubicin,cyclophosphamide and prednisone（VDCP）].After 5-year follow-up,13 cases achieved complete remission（CR）（CR group）,and 9 cases of non-remission（NR）（NR group）were enrolled.Totally,20 healthy subjects were enrolled as healthy control group.Results Compared with healthy control group,the percentage of CD4⁺CD25^high Treg in peripheral blood increased before and after treatment in ALL group（P<0.05）.The percentage of CD4⁺CD25^high Treg in CR group was increased（P<0.001）,while NR group had no statistical significance before treatment（P>0.05）.The percentage of CD4⁺CD25^high Treg after treatment was slightly lower in ALL group than that before treatment without statistical significance（P>0.05）.The percentage of CD4⁺CD25^high Treg after treatment was lower in CR group than that before treatment（P<0.01）,and it was close to that in healthy control group（P>0.05）.The percentage of CD4⁺CD25^high Treg after treatment in NR group was higher than that before treatment（P<0.01）,and it was higher than that in healthy control group（P<0.001）.Conclusions CD4⁺CD25^high Treg in peripheral blood may be used as an indicator for the treatment efficiency of ALL.更多还原