南京医科大学学报（自然科学版）2019，Vol.39Issue(4)：520-527,8.DOI:10.7655/NYDXBNS20190410
外周血CD4+T淋巴细胞绝对数及CD4+/CD8+比值在套细胞淋巴瘤中的预后价值
Prognostic value of absolute CD4+ T cell counts and CD4+/CD8+ ratio in peripheral blood of patients with mantle cell lymphoma
摘要
Abstract
Objective:To explore the distribution of T lymphocyte subsets in peripheral blood of patients with mantle cell lymphoma (MCL), and evaluate correlation with clinical baseline characteristics and its prognostic value.Methods:The clinical data of 92 newly diagnosed MCL patients from 2006 to 2017 were analyzed retrospectively.The prognostic stratification was performed using a simplified MCL international prognostic index s MIPI.The T lymphocyte subsets, including the absolute number of CD4+T lymphocytes (ACD4C) and the absolute number of CD8+T lymphocytes (ACD8C) were analyzed by flow cytometry.Comparisons of T lymphocyte subsets as continuous parameters in different groups were described using Mann-Whitney U test and Kruskal-Wallis.Kaplan-Meier method was used to survival analysis, and the Cox proportional hazards models were used for the estimation of prognostic factors.Results:The median follow-up was 51 months (12-150 months), and the median overall survival (OS) in 92 patients was 44 months.The OS rate at 1, 3 and 5 years was 72％, 45％and 37％, respectively.In our cohort, patients with high ACD4C (＞0.5×109/L) had longer PFS and OS (P=0.009, P=0.004), while patients with low CD4+/CD8+ratio (≤1.2) had unfavorable PFS and OS (P=0.025, P=0.009).Univariate Cox regression indicated that ECOG≥2 (P=0.021), B symptoms (fever, night sweats or weight loss) (P=0.001), elevated LDH (P=0.027), high s MIPI score (P=0.004), low ACD4C (P=0.013) and low CD4+/CD8+ratio (P=0.030) correlated with shorter PFS, while the inferior OS was associated with B symptoms (P＜0.001), high sMIPI score (P=0.004), elevated LDH (P=0.040), low ACD4C (P=0.006) and low CD4-/CD8+ratio (P=0.012).Multivariate Cox regression showed that B symptoms (P=0.006) and low ACD4C (P=0.001) were the independent prognostic factors of PFS;B symptoms (P=0.003), high sMIPI score (P=0.047), low ACD4C (P=0.001), low CD4+/CD8+ratio (P=0.031) were the independent prognostic factors of OS.Conclusion:Low ACD4C and low CD4+/CD8+ratio were associated with unfavorable prognosis in MCL patients.ACD4C level and CD4+/CD8+ratio proved to be convenient and effective predictors of prognosis in patients with MCL.关键词
套细胞淋巴瘤/CD4+T淋巴细胞绝对数/CD4+/CD8+比值/预后Key words
mantle cell lymphoma/absolute CD4+ T cell count/CD4+/CD8+ ratio/prognosis分类
医药卫生引用本文复制引用
周晓慧,王莉,朱华渊,李建勇,徐卫..外周血CD4+T淋巴细胞绝对数及CD4+/CD8+比值在套细胞淋巴瘤中的预后价值[J].南京医科大学学报（自然科学版）,2019,39(4):520-527,8.基金项目
国家自然科学基金(81770166,81370657) （81770166,81370657）
