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目的:探讨CD4+CD25+调节性T细胞检测在急性髓细胞白血病(AML)中的临床意义。方法:选取AML患者41例和体检健康者16例,用流式细胞仪检测CD4+CD25+调节性T细胞占CD4+T细胞的比例。结果:AML患者外周血的CD4+CD25+调节性T细胞表达明显高于对照者[(3.88±1.99)%∶(1.96±1.66)%,P<0.01]。AML组内,化疗耐药者(15例)的CD4+CD25+调节性T细胞表达显著高于化疗敏感者(14例)[(3.90±1.89)%∶(2.00±1.65)%,P<0.01]。14例化疗敏感者中,缓解后复发者(4例)的CD4+CD25+调节性T细胞表达显著高于持续缓解者(10例)[(3.95±1.86)%∶(2.02±1.55)%,P<0.05]。结论:CD4+CD25+调节性T细胞可能诱导免疫耐受,从而导致AML细胞的恶性增殖,影响白血病化疗的疗效,也可能是引起缓解患者复发的原因之一。
Objective: To investigate the clinical significance of the detection of CD4+CD25+ regulatory T cells in acute myeloid leukemia (AML). METHODS: Forty-one patients with AML and 16 healthy controls were enrolled. The proportion of CD4+CD25+ regulatory T cells to CD4+ T cells was measured by flow cytometry. RESULTS: The expression of CD4+CD25+ regulatory T cells in peripheral blood of AML patients was significantly higher than that in the controls [(3.88±1.99)%:(1.96±1.66)%, P<0.01]. In the AML group, the expression of CD4+CD25+ regulatory T cells in chemotherapy-resistant patients (15 cases) was significantly higher than that in chemotherapy-sensitive patients (14 cases) [(3.90±1.89)%: (2.00±1.65)%, P<0.01] . Among 14 patients with chemotherapy sensitivity, the expression of CD4+CD25+ regulatory T cells in relapsed patients (4 cases) was significantly higher than that in continuous remission (10 cases) [(3.95±1.86)%: (2.02±1.55)%, P <0.05]. Conclusion: CD4+CD25+ regulatory T cells may induce immune tolerance, leading to the malignant proliferation of AML cells, affecting the efficacy of leukemia chemotherapy, and may also be one of the causes of relapse in patients with remission.