弥漫大 B 细胞淋巴瘤患者 Th17细胞及相关细胞因子水平与预后的关系

目的：探讨弥漫大B细胞淋巴瘤（ DLBCL）患者Th17细胞及相关细胞因子水平与预后的关系及其意义。方法将60例DLBCL患者按照国际预后指数（IPI）评分分为低中危组32例和中高危组28例，另选健康者30例作为对照组。采用流式细胞术检测各组外周血中Th17细胞比例，ELISA检测外周血相关细胞因子白细胞介素（ IL）－17、IL－21、IL－23、转化生长因子－β（ TGF－β）的表达水平，分别比较各组之间Th17细胞及相关细胞因子水平的差异，并分析其与IPI评分的相关性；分析随访的54例患者Th17细胞水平与生存率的关系。结果（1）中高危组Th17细胞、IL－17、IL－21均低于对照组和低中危组，IL－23低于对照组，TGF－β高于对照组和低中危组，差异均有统计学意义（P＜0．05）。（2）DLBCL患者Th17细胞、IL－17、IL－21与IPI评分呈负相关，TGF－β与IPI评分呈正相关，相关性有统计学意义（P＜0．05）。（3）高Th17细胞者和低Th17细胞者3年生存率分别为82．1％和45．0％，Th17细胞水平对DLBCL患者生存的影响有统计学意义（P＝0．021）。结论 DLBCL患者Th17细胞及相关细胞因子水平与IPI评分密切相关，Th17细胞与IPI评分呈负相关。 Th17细胞对预后有影响，可能在DLBCL的发生发展中起着抑制作用。

Relationship between prognosis and Th17 cells together with related cytokines in diffuse large B-cell lymphoma patients

Objective To investigate the correlation of levels of Th 17 related cytokines in diffuse large B -cell lymphoma ( DLBCL) patients with prognosis and its significance .Methods 60 DLBCL patients were divided into two groups according to IPI.There were 32 cases in the low-intermediate risk group (LIR group) and 28 cases in the inter-mediate-high risk group (IHR group).30 cases of healthy individuals served as the control group (C group).The per-centage of Th17 cells in the peripheral blood in each subgroup was tested by flow cytometry .The cytokines IL-17, IL-21, IL-23, and TGF-βin the peripheral blood were measured by enzyme -linked immunosorbent assay(ELISA).Uni-variate survival analysis was used to analyse the correlation between survival and Th 17 cell percentage in 54 follow-up DLBCL patients.Results ①The percentage of Th17 cells and the levels of IL -17, IL-21 in the IHR group were sig-nificantly lower than that in the LIR group and C group (P<0.05).The level of IL-23 in the IHR group was significant-ly lower than C group .The level of TGF-βin the IHR group was significantly higher than that in the LIR group and C group (P<0.05).②The percentage of Th17 cells and the levels of IL -17 and IL-21 in DLBCL patients were nega-tively correlated with IPI .The level of TGF -βwas positively correlated with IPI .③ The 3-year survival of the high Th17 group and low Th17 group were 82.1%and 45.0%, respectively.Percentage of Th17 cells was an independent fac-tor in the survival of DLBCL patients (P=0.021).Conclusion The percentage of Th17 cells and related cytokines in DLBCL patients are closely correlated with IPI .Percentage of Th17 cells is negatively correlated with IPI .Percentage of Th17 cells is an independent factor in the prognosis of DLBCL patients .Th17 cells might have an inhibitory effect in the development of DLBCL .