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本研究了解B细胞肿瘤患者胸腺近期输出naiveT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-NHL17例,MM14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±3.42/1000PBMNC和5.87±4.96/1000CD3+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/1000PBMNC和2.01±3.93拷贝/1000CD3+细胞(p=0.0005和p=0.0123),在B-CLL为0.11±0.15拷贝/1000PBMNC,0.23±0.27拷贝/1000CD3+细胞(p=0.0015和p=0.0381),在B-NHL为0.71±1.34拷贝/1000PBMNC(p=0.0017),在MM为0.53±0.90拷贝/1000PBMNC(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naiveT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。
This study was to investigate the level of naive T cells in the thymus of patients with B cell tumors in order to evaluate their T cell immune potential. The peripheral blood mononuclear cells (PBMNC) from 61 B-cell tumor patients (20 adult B-ALL patients, 6 children B-ALL patients, 4 B-CLL patients, 17 B-NHL patients and 14 MM patients) were detected by real-time quantitative PCR (TaqMan) T-cell receptor rearrangement excision circles (TREC) content was calculated and the level of TREC in CD3 cells was calculated according to the positive rate of CD3 in peripheral blood. 5 cases of ALL-CR patients and 17 cases of normal peripheral blood as a control. The results showed that the TREC copy number in peripheral blood of normal people was 3.76 ± 3.42 / 1000PBMNC and 5.87 ± 4.96 / 1000CD3 + cells, while the TREC level in each B cell tumor group was significantly lower than that in normal people, and the TREC level in normal B- ALL were 0.53 ± 1.52 copies / 1000 PBMNC and 2.01 ± 3.93 copies / 1000 CD3 + cells (p = 0.0005 and p = 0.0123), 0.11 ± 0.15 copies / 1000 PBMNC at B-CLL, p = 0.0381), 0.71 ± 1.34 copies / 1000 PBMNC (p = 0.0017) at B-NHL and 0.53 ± 0.90 copies / 1000 PBMNC (p = 0.0018) at MM. The level of TREC in ALL-CR group was also lower than that in normal people, and the TREC level in B-ALL group was significantly higher than that in adult group. CONCLUSION: The function of naive T cells in thymus of all kinds of B-cell tumors was significantly reduced, with large individual differences. The output function of thymus was still not restored at the time of complete remission, suggesting the necessity of dynamic observation of the patients.