本文選題：慢性粒細(xì)胞白血病　切入點(diǎn)：巨噬細(xì)胞　出處：《廣東醫(yī)學(xué)》2017年05期 　論文類(lèi)型：期刊論文

【摘要】：目的探討慢性粒細(xì)胞白血病(CML)患者骨髓中巨噬細(xì)胞及白細(xì)胞介素(IL)-1β、IL-2、IL-4、IL-10、γ干擾素(INF-γ)的表達(dá)及相關(guān)性以明確其臨床意義。方法選擇CML慢性期30例(CML-CP組)、加速期21例(CML-AP組)、急變期20例(CML-BP組)、經(jīng)治療后完全緩解的患者44例、未緩解7例以及30例缺鐵性貧血患者(對(duì)照組),采用免疫組化染色法檢測(cè)上述各組患者骨髓組織中CD68、CD163的表達(dá)變化;應(yīng)用流式細(xì)胞儀分析相應(yīng)患者骨髓IL-1β、IL-2、IL-4、IL-10、INF-γ表達(dá);比較骨髓巨噬細(xì)胞在CML患者不同時(shí)期骨髓組織CD68、CD163的表達(dá)差異與IL-1β、IL-2、IL-4、IL-10、INF-γ表達(dá)變化的關(guān)系。結(jié)果 CML各組患者骨髓組織中CD68、CD163均有不同程度的表達(dá),且隨著病情的進(jìn)展表達(dá)逐漸增高,即對(duì)照組CML-CP組CMLAP組CML-BP組,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);同時(shí),CD163與CD68陽(yáng)性細(xì)胞數(shù)密切相關(guān)(P0.05)。與對(duì)照組比較,CML-CP組骨髓IL-2、INF-γ明顯降低(P0.05),IL-1β、IL-4、IL-10表達(dá)明顯升高(P0.05);隨著病情進(jìn)展,IL-2、INF-γ表達(dá)逐漸降低,即對(duì)照組CML-CP組CML-AP組CML-BP組,其組間差異有統(tǒng)計(jì)學(xué)意義(P0.05),且與CD163表達(dá)呈負(fù)相關(guān);IL-1β、IL-4、IL-10表達(dá)逐漸升高,對(duì)照組CML-CP組CML-AP組CML-BP組,組間差異有統(tǒng)計(jì)學(xué)意義(P0.05),并與CD163表達(dá)呈正相關(guān)。患者經(jīng)治療完全緩解后,CD68及CD163仍高于對(duì)照組(P0.05);IL-2、INF-γ有所回升,但仍低于對(duì)照組(P0.05),IL-1β、IL-4、IL-10有所降低,同樣也高于對(duì)照組(P0.05)。未緩解組所測(cè)指標(biāo)與CML-BP組相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論巨噬細(xì)胞在CML患者骨髓中的異常浸潤(rùn)并逐漸從M1型向M2型巨噬細(xì)胞激化及IL-1β、IL-2、IL-4、IL-10、INF-γ的異常表達(dá),改變了正常骨髓微環(huán)境,有利于白血病細(xì)胞的生存和增殖分化,可能與CML的發(fā)生、發(fā)展相關(guān)。
[Abstract]:Objective to investigate the expression and correlation of macrophage and IL-2IL-4IL-10, interferon 緯 (IFN- 緯) in bone marrow of patients with chronic myelogenous leukemia (CML). Methods 30 cases of chronic CML with CML-CP and 21 cases of accelerated stage with CML-AP were selected. There were 20 cases of CML-BP group and 44 cases of complete remission after treatment. The expression of CD68 ~ + CD163 in bone marrow of 7 patients without remission and 30 patients with iron deficiency anemia (control group) was detected by immunohistochemical staining, and the expression of IL-1 尾 -2IL-4IL-4IL-4IL-10 / INF- 緯 in bone marrow was analyzed by flow cytometry. To compare the relationship between the expression of CD68 / CD163 in bone marrow tissue of CML patients and the expression of IL-1 尾 -IL-2mIL-4 / IL-10 / INF- 緯 in bone marrow tissue of patients with CML. Results the expression of CD68 / CD163 in bone marrow tissue of CML patients was increased gradually with the progression of the disease. There was a significant difference between the CML-BP group and the control group (P 0.05), while CD163 was closely related to the number of CD68 positive cells. Compared with the control group, the expression of IL-2INF- 緯 in the bone marrow of the CML-CP group was significantly lower than that in the control group, and the expression of IL-4 IL-10 in the bone marrow of the CML-CP group was significantly higher than that in the control group, and the expression of IL-2INF- 緯 decreased gradually with the progression of the disease. The difference between CML-BP group and CML-CP group was statistically significant (P 0.05), and the expression of IL-10 was negatively correlated with the expression of IL-1 尾, IL-4 and IL-10 in CML-BP group, and the CML-BP group in CML-AP group in CML-CP group, and the expression of IL-10 in CML-BP group was significantly higher than that in control group (P < 0.05). The difference between the two groups was statistically significant and positively correlated with the expression of CD163. After complete remission, the levels of CD68 and CD163 in the patients were still higher than those in the control group (P 0.05), and the levels of IL-2INF- 緯 were higher than those in the control group, but they were still lower than those in the control group. It was also higher than the control group (P 0.05). There was no significant difference in the indexes measured between the non-remission group and the CML-BP group. Conclusion the abnormal infiltration of macrophages in the bone marrow of CML patients and the gradual aggravation from M1 type to M2 type macrophage and the abnormal expression of IL-1 尾 IL-2mIL-4 IL-4 IL-10 IL-10 INF- 緯 in the bone marrow of patients with CML. The change of normal bone marrow microenvironment is beneficial to the survival and proliferation and differentiation of leukemic cells, which may be related to the occurrence and development of CML.
【作者單位】： 云南省第一人民醫(yī)院血液學(xué)診斷室;云南省第一人民醫(yī)院血液科;云南省第一人民醫(yī)院臨床基礎(chǔ)研究所;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(編號(hào):31460298) 云南省科技廳-昆明醫(yī)科大學(xué)聯(lián)合專(zhuān)項(xiàng)應(yīng)用基礎(chǔ)研究項(xiàng)目資助(編號(hào):2014FZ070)
【分類(lèi)號(hào)】：R733.72

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