B淋巴细胞肿瘤患者胸腺近期的输出功能

本研究了解B细胞肿瘤患者胸腺近期输出naiveT细胞的水平,以评价其T细胞免疫潜能。利用实时定量PCR(TaqMan)方法检测61例B细胞肿瘤患者(成人B-ALL20例,儿童B-ALL6例,B-CLL4例,B-NHL17例,MM14例)外周血单个核细胞(PBMNC)中T细胞受体重排删除DNA环(T-cell receptor rearrangement excision circles,TREC)的含量,并根据外周血中CD3阳性率计算CD3细胞中TREC水平。5例ALL-CR病人和17例正常人外周血作为对照。实验结果显示,正常人外周血中TREC拷贝数为3.76±3.42/1000PBMNC和5.87±4.96/1000CD3 细胞,而各B细胞肿瘤组的TREC水平均显著低于正常人水平,其TREC水平在成人B-ALL为0.53±1.52拷贝/1000PBMNC和2.01±3.93拷贝/1000CD3 细胞(p=0.0005和p=0.0123),在B-CLL为0.11±0.15拷贝/1000PBMNC,0.23±0.27拷贝/1000CD3 细胞(p=0.0015和p=0.0381),在B-NHL为0.71±1.34拷贝/1000PBMNC(p=0.0017),在MM为0.53±0.90拷贝/1000PBMNC(p=0.0018)。ALL-CR组TREC水平同样低于正常人水平,儿童B-ALL组TREC水平明显高于成人组。结论:各类B细胞肿瘤胸腺近期输出naiveT细胞功能均明显降低,个体差异较大,在病人达到完全缓解期时,胸腺近期输出功能仍没有得到恢复,提示对病人有动态观察的必要性。

Thymic Recent Output Function in Patients with B-cell Lymphocytic Malignancies

The aim of the study was to analyze the naive T cell level of thymic recent output in patients with B-cell malignancies, thereby to evaluate the potential T-cell function. Quantitative analysis of T-cell receptor rearrangement excision circles (TRECs) in DNA of peripheral blood mononuclear cells from 61 cases of B-cell lymphocytic malignancy (including 20 cases of adult B-ALL, 6 case of childhood B-ALL, 4 cases of B-CLL, 17 cases of B-NHL and 14 cases of MM) were preformed by real-time PCR (TaqMan), and TREC-level was detected according to the number of CD3-positive cells. 5 case of ALL-CR and 17 normal individuals were served as controls. The results showed a dramatic reduction of TREC values in all groups of patients. The mean value of TRECs was 0.53 +/- 1.52 copies/1000 PBMNC and 2.01 +/- 3.93 copies/1000 CD3+ cells in adult B-ALL (p = 0.0005, p = 0.0123), 0.11 +/- 0.15 copies/1000 PBMNC and 0.23 +/- 0.27 copies/1000 CD3+ cells in B-CLL (p = 0.0015, p = 0.0381), 0.71 +/- 1.34 copies/1000 PBMNC in B-NHL (p = 0.0017), 0.53 +/- 0.90 copies/1000 PBMNC in MM patients (p = 0.0018), as compared with 3.76 +/- 3.42 copies/1000 PBMNC and 5.87 +/- 4.96 copies/1000 CD3+ cells in normal individuals, the TREC level was significantly decreased in all groups of B-cell lymphocytic malignancy, as well as in ALL-CR group. However, the TREC level in childhood B-ALL was significant higher than those in adult B-ALL group. It is concluded that the function of thymic recent outputting naive T cells in B-cell malignancies significantly decreases, however, the individual difference of thymic output function is obvious. The thymic recent output function can not be recovered during CR phase in patients with B-cell malignancies, so that dynamic analysis of TREC level is necessary.