急性淋巴细胞白血病患儿外周血T细胞表面CD28、CTLA-4的表达及其临床意义

【作者】 杨娜；

【导师】 刘华林；

【作者基本信息】 青岛大学 ， 儿内科， 2010， 硕士

【摘要】 目的探讨急性淋巴细胞白血病患儿外周血T细胞上共刺激分子CD28、CTLA-4表达及其临床意义。方法利用流式细胞仪(FCM)技术检测21例初发急性淋巴细胞白血病患儿(其中5例为高白细胞患儿)和20例正常儿童外周血淋巴细胞CD4+和CD8+T细胞表面CD28和CTLA-4的表达,比较CD4/CD8的比例变化,分析其与白血病发病的关系。结果与正常对照组比较，ALL患儿外周血CD4+T淋巴细胞上CD28的表达明显下降(t=4.796，p<0.05)；CD8+T淋巴细胞上CD28的表达明显下降(t=3.551,p<0.05)。CD4+T淋巴细胞上CTLA-4的表达明显升高(t=5.07，p<0.05)；CD8+T淋巴细胞上CTLA-4的表达明显升高(t=5.469，p<0.05)。高白细胞组与低白细胞组比较,CD4+和CD8+T淋巴细胞上CD28的表达差异均没有统计学意义(t=0.16,t=0.712,p>0.05)：CTLA-4的表达也没有明显的统计学意义(t=0.363，t=0.65,p>0.05)。ALL患儿外周血CD4/CD8明显下降(t=3.477,p<0.05),差异有统计学意义。结论ALL患儿外周血T淋巴细胞上CD28表达下降,CTLA-4的表达升高；CD4+的T细胞数量下降,CD4/CD8比值下降,提示T淋巴细胞的免疫活化能力降低,免疫监视功能下降,可能是ALL的发病机制之一。更多还原

【Abstract】 Objective To investigate the expression of costimulatory molecules CD28 and CTLA-4 on peripheral blood T lymphocytes in patients with Acute Lymphoblastic Leukemia(ALL) and to explore their possible clinical significance.Methods The expression of costimulatory molecules CD28 and CTLA-4 on CD4+and CD8+T cells were measured in 21 patients(5 patients with high white blood cell) with newly diagnosed ALL and 20 healthy subjects as control group by flow cytometry(FCM).The expression of the peripheral blood T lymphocyte subsets CD4/CD8 was compared and its relationships with ALL was analyzed.Results The level of CD28 on CD4+T cells and on CD8+T cells of ALL were significantly decreased compared with normal controls(t=4.796,t=3.551 respectively, p<0.05);The levels of CTLA-4 on CD4+T cells and on CD8+T cells of ALL were significantly increased compared with normal controls(t=5.07,t=5.469 respectively, p<0.05). The level of CD28 on CD4+and CD8+T cell had no statistical significance between high and low white blood cell group(t=0.160, t=0.712 respectively, p>0.05). And the level of CTLA-4 also had no statistical significance(t=0.363, t=0.650 respectively,p>0.05). The level of CD4/CD8 was significantly decreased in ALL patients than in normal controls (t=3.477, p<0.05).Conclusion The expression of CD28 on peripheral blood T cell in ALL patients was decreased, however, the expression of CTLA-4 was up-regulated. The CD4+T cell and the ratio of CD4/CD8 were also decreased, which were suggested that the ability of immune activation in T cell was decreased, and the immune surveillance also descended, these may be one of the pathogenesis of ALL.更多还原