中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (10): 765-769.doi: 10.3969/j.issn.1007-3969.2014.10.009

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合并乙肝病毒感染对弥漫大B细胞淋巴瘤患者细胞免疫功能的影响

魏征,程韵枫,王志梅,邹善华   

  1. 复旦大学附属中山医院血液科,上海 200032
  • 出版日期:2014-10-30 发布日期:2014-11-12
  • 通信作者: 邹善华 E-mail:zou.shanhua@zs-hospital.sh.cn
  • 作者简介:邹善华,副主任医师,副教授,复旦大学附属中山医院血液科副主任,中华医学会上海分会血液学专科委员会委员兼秘书,中国淋巴瘤联盟委员;兼任《中华血液学杂志》通讯编委及《实用内科学》第14版编委。主要从事血液肿瘤临床和相关研究工作。参编专著8部,在国内外期刊上发表论文40余篇。

The impact of hepatitis B virus concurrent infection on peripheral T cells in diffuse large B cell lymphoma patients

WEI Zheng, CHENG Yun-feng, WANG Zhi-mei, ZOU Shan-hua   

  1. Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
  • Published:2014-10-30 Online:2014-11-12
  • Contact: ZOU Shan-hua E-mail: zou.shanhua@zs-hospital.sh.cn

摘要:

背景与目的:乙型肝炎病毒(hepatitis virus BHBV)感染与弥漫大B细胞淋巴瘤(diffuse large B cell lymphomaDLBCL)密切相关,前期研究发现在接受联合免疫化疗的DLBCL患者中,HBsAg阳性者生存较差,但具体机制有待进一步证实。本研究通过分析HBV感染对DLBCL患者细胞免疫的影响,为阐明这一机制寻找细胞免疫方面的证据。方法:20043月—20136月共294例住院初治的DLBCL患者纳入本研究。采用四色流式分析患者外周血CD3+CD4+CD8+细胞计数及CD4+/CD8+细胞比例,比较HBsAg阳性及阴性的DLBCL患者发病时、化疗后24个月、化疗后46个月及化疗后612个月上述参数的时序改变及2组间的差异。结果:HBsAg阴性患者相比,HBsAg阳性DLBCL患者化疗前各淋巴细胞亚群差异无统计学意义(P>0.05);外周血CD4+细胞计数在化疗后24个月显著低于HBsAg阴性患者;HBsAg阳性患者CD4+/CD8+比例降低,在化疗后412个月显著低于HBsAg阴性患者。结论:合并HBV感染对DLBCL患者化疗前细胞免疫状态无明显影响;HBsAg阳性的DLBCL患者化疗后出现更为明显和持续的细胞免疫抑制。

关键词: 弥漫大B细胞淋巴瘤, 细胞免疫, 化疗

Abstract:

Background and purpose: The clinical relevance of HBV infection with respect to diffuse large B cell lymphoma(DLBCL) patients and immune patterns of T lymphocyte subsets during chemotherapy remains unclear. This study aimed to identify the characteristics of T-cell mediated immunity in DLBCL patients with HBV infection, thereafter, to explore the possible cell-mediated immune mechanisms of HBsAg positive HBV infection on the survival of DLBCL. Methods: A total of 294 newly diagnosed DLBCL patients were enrolled in this cohort study. Four-color flow cytometric method was used to enumerate the absolute number of CD3+, CD4+, CD8+ T lymphocytes and the CD4+/CD8+ ratio in peripheral blood samples, at the onset of disease, 2-4, 4-6 and 6-12 months after the initiation of chemotherapy, individually. Results: The absolute number of CD3+, CD4+, CD8+ T lymphocytes in both groups were similar at the onset of disease; the count of CD4+ lymphocytes was lower in HBsAg positive group during 2 to 4 months after the initiation of chemotherapy, compared with that in the HBsAg negative group. During 4 to 12 months after chemotherapy, the CD4+/CD8+ ratio in peripheral blood samples was significantly lower in HBsAg positive group. Conclusion: For newly diagnosed DLBCL patients who received chemotherapy, the dynamic nature of cell mediated immune response was characterized as a low counts of CD4+ T lymphocyte during the first several cycles of chemotherapy followed by a decreased circulating CD4+/CD8+ ratio. Depressions of cell immunity after chemotherapy in HBsAg positive DLBCL patients were greater and prolonged.

Key words: Diffuse large B cell lymphoma, Cell immunity, Chemotherapy