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目的:观察急性髓系白血病(Acute myelogenous leukemia,AML)患者外周血中调节性T细胞(Regulatory Tcells,Treg细胞)的变化,探讨其在AML发病中的作用及临床意义。方法:应用流式细胞术检测31例初诊AML患者(初诊组)、23例经化疗取得完全缓解患者(CR组)及20例健康人群(对照组)外周血CD4+CD25highFOXP3+Treg细胞、CD4+FOXP3+T细胞占CD4+细胞的比例,同时还分析了外周血CD4+/CD8+比值、NK细胞及血清乳酸脱清酶(LDH)水平。结果:与对照组相比较,AML患者初诊组及CR组外周血CD4+CD25highFOXP3+Treg细胞和CD4+FOXP3+T细胞均升高(P<0.01)。与初诊组相比较,CR组CD4+CD25highFOXP3+Treg细胞无显著降低(P>0.05),CD4+FOXP3+T细胞明显下降(P<0.01)。CD4+CD25highFOXP3+Treg细胞的升降与CD4+FOXP3+T细胞呈正相关(r=0.86;P<0.01)。CD4+CD25highFOXP3+Treg细胞及CD4+FOXP3+T细胞比例与CD4+/CD8+比值呈负相关(r分别为-0.54、-0.52;P<0.01)、与NK细胞比例呈负相关(r分别为-0.41、-0.43;P<0.05),而与LDH水平呈正相关(r分别为0.51、0.57;P<0.05)。结论:CD4+CD25highFOXP3+Treg细胞增多可能是AML患者免疫功能受抑的重要原因之一,其变化对于AML的预后判断有一定的意义。CD4+FOXP3+T细胞的作用类似于CD4+CD25highFOXP3+Treg细胞,其在AML疗效评价方面可能更有价值。
Objective: To observe the changes of regulatory T cells (Treg cells) in peripheral blood of patients with acute myelogenous leukemia (AML) and to explore its role in the pathogenesis of AML and its clinical significance. Methods: Flow cytometry was used to detect the percentage of CD4 + CD25high FOXP3 + Treg cells, CD4 + CD25 + Treg cells in peripheral blood of 31 newly diagnosed AML patients (newly diagnosed group), 23 patients with complete remission after chemotherapy (CR group) and 20 healthy controls The ratio of CD4 + / CD8 +, NK cells and serum lactate decarboxylase (LDH) in peripheral blood was also analyzed. Results: Compared with the control group, CD4 + CD25high FOXP3 + Treg cells and CD4 + FOXP3 + T cells in peripheral blood of newly diagnosed and CR patients in AML group were significantly increased (P <0.01). Compared with the newly diagnosed group, the CD4 + CD25high FOXP3 + Treg cells in CR group were not significantly decreased (P> 0.05), and the CD4 + FOXP3 + T cells were significantly decreased (P <0.01). The elevation of CD4 + CD25high FOXP3 + Treg cells was positively correlated with CD4 + FOXP3 + T cells (r = 0.86; P <0.01). The proportion of CD4 + CD25high FOXP3 + Treg cells and CD4 + FOXP3 + T cells was negatively correlated with the ratio of CD4 + / CD8 + (r = -0.54, -0.52, P <0.01, respectively) , -0.43; P <0.05), but positively correlated with LDH level (r = 0.51,0.57, P <0.05). Conclusion: The increase of CD4 + CD25high FOXP3 + Treg cells may be one of the important reasons for the suppression of immune function in AML patients. The change of AML patients’ prognosis is of certain significance. The role of CD4 + FOXP3 + T cells is similar to that of CD4 + CD25high FOXP3 + Treg cells, which may be more valuable in the evaluation of AML efficacy.