医学毕业b淋巴细胞肿瘤患者胸腺近期的输出功能.docxVIP

XX大学 毕业论文 B淋巴细胞肿瘤患者胸腺近期的输出功能 2014年6月25日 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 ALL20例，儿童B ALL6例，B CLL4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 reanangement 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/I 000 CD3+细胞，而各B细胞肿瘤组的TREC水平均显著 低于止常人水平，其TREC水平在成人B ALL为0.53±1.52拷贝/I 000 PBMNC 和 2.0H3.93 拷贝/I 000 CD3+细胞(p=0.0005 和 p=0.0123),在 B CLL 为 0.1H0.15 拷贝/I 000 PBMNC, 0.23±0.27 拷贝/I 000 CD3+细胞(p=0.0015 和 p=0.0381),在 B NHL 为 0?71±1?34 拷贝/I 000 PBMNC (p=0.0017),在 MM 为 0.53±0.90 拷贝/I 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 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 /I 000 PBMNC and 2.01±3.93 copies /I 000 CD3+cells in adult B ALL (p=0.0005, p=0.0123), 0.11±0.15 copies /I 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 /I 000 PBMNC in B NHL (p=0.0017), 0.53±0.90 copies /I 000 PBMNC in MM patients (p=0.0018), as co