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套细胞淋巴瘤外周血CD4+/CD8+比值与预后的相关性分析

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目的:探索外周血T淋巴细胞亚群对套细胞淋巴瘤(MCL)患者生存预后的影响,以及与临床特征之间的相关性.方法:回顾性分析2012年1月至2022年7月于山西医科大学第二医院血液内科初诊的55例MCL患者的病历资料,流式细胞术检测外周血T淋巴细胞各亚群百分比及CD4+/CD8+比值,并分析其与患者临床特征之间的相关性;Kaplan-Meier法进行生存分析,并绘制生存曲线,运用log-rank检验进行单因素分析,Cox比例风险回归模型进行多因素分析.结果:中位随访40(1-68)个月,55例患者的中位总生存期(OS)为47个月.55例患者中30例(54.5%)外周血CD4+T淋巴细胞比例下降,17例(30.9%)外周血CD8+T淋巴细胞比例升高,20例(36.4%)CD4+/CD8+比值下降.CD4+/CD8+比值与性别、年龄、Ki-67、B症状、白细胞、血红蛋白、淋巴细胞、血小板、白蛋白、乳酸脱氢酶、β2-微球蛋白、脾脏肿大、骨髓侵犯、原发部位、MIPI评分等临床特征均无显著相关性.生存分析结果显示,CD4+T细胞比例>23.3%、CD8+T细胞比例≤33.4%及CD4+/CD8+比值>0.6的患者OS更长(P=0.020,P<0.001,P<0.001).单因素分析结果显示,Ki-67>30%、乳酸脱氢酶>250 U/L、脾脏肿大、骨髓受累、CD4+T细胞≤23.3%、CD8+T细胞>33.4%、CD4+/CD8+比值≤0.6是影响患者OS的不良预后因素.多因素分析显示,CD4+/CD8+比值≤0.6(HR=4.382,P=0.005)为MCL患者OS的独立不良预后相关因素.结论:低CD4+/CD8+比值为MCL患者的不良预后因素,CD4+/CD8+比值可作为判断MCL患者预后风险的重要指标.
Correlation of CD4+/CD8+Ratio in Peripheral Blood with Progno-sis of Mantle Cell Lymphoma
Objective:To investigate the correlation of peripheral blood T lymphocyte subsets with overall survival(OS)and clinical baseline characteristics in mantle cell lymphoma(MCL).Methods:The clinical data of 55 MCL patients who were newly diagnosed in the Department of Hematology,Second Hospital of Shanxi Medical University from January 2012 to July 2022 were analyzed retrospectively.The percentages of T lymphocyte subsets and CD4+/CD8+ratio in peripheral blood were detected by flow cytometry,and their correlation with clinical characteristics of patients were analyzed.Kaplan-Meier method was used for survival analysis and survival curves were drawn.Log-rank test was used for univariate analysis,while Cox proportional hazards model was used for multivariate analysis.Results:The median follow-up was 40(1-68)months,and the median overall survival(OS)was 47 months.Among the 55 patients,30(54.5%)patients had a decrease in peripheral blood CD4+T lymphocyte,while 17(30.9%)patients had a increase in peripheral blood CD8+T lymphocyte,and 20(36.4%)patients had a decrease in CD4+/CD8+ratio.There were no significant correlations between CD4+/CD8+ratio and sex,age,Ki-67,B symptoms,leukocytes,hemoglobin,lymphocytes,platelets,albumin,lactate dehydrogenase(LDH),β2-microglobulin,splenomegaly,bone marrow invasion,primary site and MIPI score.Survival analysis showed that patients with CD4+T cell>23.3%,CD8+Tcell ≤33.4%and CD4+/CD8+ratio>0.6 had longer OS(P=0.020,P<0.001,P<0.001).Univariate analysis showed that Ki-67>30%,LDH>250 U/L,splenomegaly,bone marrow involvement,CD4+T cells 23.3%,CD8+T cells>33.4%,CD4+/CD8+ratio ≤0.6 were adverse prognostic factors affecting OS of MCL patients.Multivariate analysis showed that CD4+/CD8+ratio ≤0.6(HR=4.382,P=0.005)was an independent adverse prognostic factor for OS of MCL patients.Conclusions:Low CD4+/CD8+ratio is associated with poor prognosis in MCL,and the CD4+/CD8+ratio can be used as an important indicator to evaluate the prognosis risk in MCL patients.

mantle cell lymphomaCD4+/CD8+ratioprognosis

李燕玲、秦小琪、郭路瑶、侯晓旭、晁瑶、马艳萍

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山西医科大学第二临床医学院,山西医科大学第二医院血液内科,山西太原 030001

套细胞淋巴瘤 CD4+/CD8+ 预后

2024

中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCD北大核心
影响因子:0.988
ISSN:1009-2137
年,卷(期):2024.32(4)
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