B淋巴细胞肿瘤患者胸腺近期输出功能.docVIP

B淋巴细胞肿瘤患者胸腺近期输出功能 　 作者：李扬秋，吴秀丽，杨力建，陈少华，耿素霞 【摘要】 本研究了解B细胞肿瘤患者胸腺近期输出naive T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ALL 20例，儿童BALL 6例，BCLL 4例，BNHL 17例，MM 14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±3.42/1 000 PBMNC和5.87±4.96 /1 000 CD3+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/1 000 PBMNC和2.01±3.93拷贝/1 000 CD3+细胞（p=0.0005和p=0.0123），在BCLL为0.11±0.15拷贝/1 000 PBMNC，0.23±0.27拷贝/1 000 CD3+细胞（p=0.0015和p=0.0381），在BNHL为0.71±1.34拷贝/1 000 PBMNC（p=0.0017），在MM为0.53±0.90拷贝/1 000 PBMNC（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naive T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。 【关键词】 胸腺近期输出功能 Thymic Recent Output Function in Patients with Bcell Lymphocytic Malignancies Abstract 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 rearrangcment 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 /1 000 PBMNC and 2.01±3.93 copies /1 000 CD3+cells in adult BALL (p=0.0005, p=0.0123), 0.11±0.15 copies /1 000 PBMNC and 0.23±0.27 copies/1 000 CD3+cells in BCLL (p=0.0015, p=0.0381), 0.71±1.34 copies /1 000 PBMNC in BNHL (p=0.0017), 0.53±0.90 copies /1 000 PBMNC in MM patients (p=0.0018), as compared with 3.76±3.42 copies /1 000 PBMNC and 5