调节性T细胞在慢性粒细胞白血病中的表达及临床意义

周莉; 徐运孝

doi:10.3969/j.issn.1000-8179.2012.09.006

调节性T细胞在慢性粒细胞白血病中的表达及临床意义

doi: 10.3969/j.issn.1000-8179.2012.09.006

周莉^①, ,,
徐运孝^②

①.
天津医科大学附属肿瘤医院生物治疗科，肿瘤研究所免疫室，天津市肿瘤防治重点实验室（天津市300060）
②.
中南大学湘雅二医院血液科

详细信息

通讯作者:
周莉 zszhouli@gmail.com

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出版历程
- 收稿日期: 2012-01-29
- 修回日期: 2012-04-16

Expression and Clinical Significance of Regulatory T Cells in Chronic Myelogenous Leukemia

Li ZHOU^{①
, ,},
Yunxiao XU^②

①.
Department of Biotherapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
②.
Department of Hematology, The Second Xiangya Hospital of Central South University, Changsha 410011, China

More Information

Corresponding author: Li ZHOU, E-mail: zszhouli@gmail.com

摘要

摘要: 目的分析CD4⁺CD25⁺Treg细胞在慢性粒细胞白血病（CML）患者不同病程中的表达，探讨其与该疾病的疗效及预后的关系，从免疫学方面揭示CML发生及转归的可能机制。方法收集23例不同病程分期CML患者及10例健康对照的外周血，采用流式细胞仪技术对CD4⁺CD25⁺Treg细胞进行检测，比较CML患者与对照之间及不同病程CML患者之间CD4⁺CD25⁺Treg细胞表达的差异；比较CD4⁺CD25⁺Treg细胞表达水平与对应的临床参数间的关系。结果与正常对照比较，CML初治患者、加速急变期患者外周血单个核细胞中CD4⁺CD25⁺Treg细胞百分比呈显著性下降（P < 0.05）；而CML慢性治疗期患者外周血单个核细胞中CD4⁺ CD25⁺Treg细胞百分比与正常对照比较无显著性差异（P>0.05）；与正常对照比较，CML初治患者、加速急变期患者外周血单个核细胞中CD4⁺Treg细胞百分比呈显著性下降（P < 0.05）；而CML慢性治疗期患者外周血单个核细胞中CD4⁺Treg细胞百分比与正常对照比较无显著性差异（P>0.05）；不同病程CML患者外周血单个核细胞中CD4⁺CD25⁺Treg细胞百分比相比较，慢性稳定期患者较初治患者有明显上升，差异有统计学意义（P < 0.05）；而其他组之间无显著性差异（P>0.05）；初治CML患者外周血单个核细胞中CD4⁺ CD25⁺Treg细胞百分比与外周血血红蛋白量呈正相关（P=0.010）；与骨髓中幼稚细胞（原始粒细胞+早幼粒细胞）百分比呈负相关（P=0.022）。结论 CML患者外周血单个核细胞中CD4⁺CD25⁺Treg细胞占外周血单个核细胞的比例下降，提示患者进入加速急变期CD4⁺CD25⁺Treg细胞在CML患者中起到一定的免疫调节作用。
- 慢性粒细胞白血病 /
- CD4⁺CD25⁺T调节细胞 /
- 肿瘤免疫
Abstract: Objective To evaluated the proportion of CD4⁺CD25⁺ Tregs cells in the peripheral blood of patients with chronic myelogenous leukemia (CML), and to investigate the correlation among the proportion of CD4⁺CD25⁺Tregs, curative effect, and prognosis of patients with CML at different phases. The onset and turnover of CML based on immunology were discussed. Methods Flow cytometry was used to determine the proportion of CD4⁺CD25⁺ Tregs in peripheral blood from 23 CML patients and 10 normal controls. The proportion was compared among CML patients, normal controls, and different phases of the disease. The correlation between the proportion of T cells and clinical parameters was analyzed. Results Compared with normal controls, the percentage of CD4 +CD25 + Tregs in the peripheral blood mononuclear cells (PBMC) was significantly lower (P < 0.05) in patients who underwent initial treatment of CML and in those with accelerated or blastic phase CML. Moreover, there were no significant differences in the percentage of CD4⁺CD25⁺ Treg cells in the PBMC of patients during treatment of CML and normal controls (P > 0.05). Percentages of CD4⁺T cells in the PBMC of patients receiving initial treatment of CML and those with accelerated or blastic phase CML was significantly lower (P < 0.05) than normal controls. There were no significant differences in CD4⁺T cell percentage in PBMC of the patients during treatment of CML and normal controls (P > 0.05). A comparison of the percentages of CD4⁺CD25⁺Treg cell in the PBMC of CML patients at various stages of the disease demonstrated an significant increase (P < 0.05) in the percentage in patients at the chronic stabilized phase compared with those in the initial treatment. No significant differences were found among the other groups (P > 0.05). There was a positive correlation between the percentage of CD4 ⁺CD25 ⁺ Treg cells in the PBMC of patients undergoing initial treatment of CML and the protein level of peripheral blood hemoglobin (P = 0.010). There was a negative correlation between PBMC of patients in initial treatment of CML and the percentage of juvenile cells in the bone marrow (progranulocyte + promyelocyte) (P = 0.022). Conclusion There is abnormal expression of CD4⁺CD25⁺ Tregs in CML patients and that the percentage of cells decreases with disease progression. A decrease in CD4⁺ T cell percentage may be used as an indicator of disease progression into the accelerated or blastic phase.CD4⁺CD25⁺ Tregs levels correlate with higher hemoglobin content and lower ratio of juvenile cells (myeloblast plus promyelocyte) in the bome marrow.
- CML /
- CD4⁺CD25⁺Tregs /
- Tumor immunity

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图 1 各组CD4⁺CD25⁺Treg细胞百分率比较

Figure 1. Comparison of the percentage of CD4⁺ CD25⁺ T cells among different groups

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图 2 CD4⁺Treg细胞在各病程间百分率比较

Figure 2. Comparison of the percentage of CD4⁺ T cells at different stages of CML

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表 1 23例CML患者的临床资料

Table 1. Clinical data of the 23 CML patients

表 2 CD4⁺CD25⁺Treg细胞表达水平与CML患者临床参数的关系

Table 2. Relationship between percentage of CD4⁺ CD25⁺ T cells and clinical parameters of CML

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