• 多种血液肿瘤中NK细胞受体表达差异的临床意义
  • 李依.多种血液肿瘤中NK细胞受体表达差异的临床意义[J].内科急危重症杂志,2022,28(3):220-224
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    DOI:10.11768/nkjwzzzz20220311
    中文关键词:  自然杀伤细胞  血液肿瘤  抑制性受体(PD-1)  活化性受体(CD69、NKG2D)
    英文关键词:
    基金项目:武汉市卫生计生委医学科研项目(No:WX21C23、WX20C38)
    作者单位E-mail
    李依 武汉科技大学医学院 cwei200408@163.com 
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    中文摘要:
          目的:检测几种血液肿瘤患者中自然杀伤(NK)细胞受体变化,以探究NK细胞功能状态。方法:收集多发性骨髓瘤(MM)患者38例,其中IgG-k型18例、IgG-λ型10例、IgA-k型4例、IgA-λ型6例;非霍奇金淋巴瘤(NHL)患者27例,其中弥漫性大B细胞淋巴瘤18例、边缘区淋巴瘤3例、滤泡性淋巴瘤1例、套细胞淋巴瘤2例、免疫母性T细胞淋巴瘤1例、外周T细胞淋巴瘤2例;慢性髓系细胞白血病(CML)患者10例;30例健康志愿者为正常对照组。通过流式细胞术测定外周血中NK细胞占有核细胞比例,用实时荧光定量聚合酶链反应(RT-qPCR)方法检测NK细胞表面抑制性受体(PD-1)及活化性受体(CD69、NKG2D)的基因表达水平。结果:与正常对照组比较,MM、NHL患者外周血NK细胞占有核细胞比例比较,差异无统计学意义(P均>0.05);而CML患者NK细胞占有核细胞数显著减少(P<0.05);MM、NHL及CML患者的NK细胞表面活化性受体(CD69、NKG2D)水平较正常对照组明显降低,NK细胞表面抑制性受体(PD-1)表达显著高于正常对照组(P均<0.05);MM、NHL及CML患者间受体(PD-1、CD69、NKG2D)表达比较,差异无统计学意义(P均>0.05)。结论:MM、NHL及CML患者外周血NK细胞表面活化性受体(CD69、NKG2D)水平明显降低,抑制性受体(如PD-1)表达明显增高,提示NK细胞功能耗竭。
    英文摘要:
          Objective: Natural killer (NK) cell receptor changes in patients with several hematological malignancies were examined to explore the functional status of NK cells. Methods: The peripheral blood samples of 38 patients with multiple myeloma(MM) were collected.There were 18 cases of IgG/(k), 10 cases of IgG/(lambda), 4 cases of IgA/(k), and 6 cases of IgA/(lambda). There were 27 cases of non-Hodgkin's lymphoma(NHL), including 18 cases of diffuse large B cell lymphoma, 3 cases of marginal zone lymphoma, one case of follicular lymphoma, 2 cases of mantle cell lymphoma, one case of angi-immmunoblastic T cell lymphoma, 2 cases of peripheral T-cell lymphoma and 10 cases of chronic myeloid cell leukemia (CML). A total of 30 healthy volunteers served as the control group.The proportion of NK cells in the peripheral blood was determined using flow cytometry, and the proportion of surface inhibitory receptor(PD-1) and activated receptors(CD69, NKG2D) in NK cells were analyzed by RT-qPCR. Results: There was no significant difference in the proportion of NK cells in peripheral blood to nuclear cells between study group (MM patients and NHL patients) and normal controls(P>0.05), but the proportion of NK cells to nuclear cells decreased in CML patients(P<0.05). The levels of NK cell surface activation receptor(CD69 and NKG2D) were significantly reduced in MM, NHL, and CML patients as compared with normal controls(P<0.05). The NK cell surface inhibitory receptor (PD-1) expression was significantly higher in MM, NHL and CML patients than in normal controls (P<0.05). No significant difference was seen in the expression of receptors (CD69, NKG2D and PD-1) among MM, NHL and CML (P>0.05). Conclusion: The surface activated receptors (CD69 and NKG2D) in peripheral blood NK cells of MM, NHL and CML patients were significantly decreased, and the high expression of inhibitory receptor (PD-1) in MM, NHL and CML patients suggests the functional depletion.