骨髓增生异常综合征患者外周血NK细胞亚型和功能分子变化的研究

发布时间：2019-07-30 15:22

【摘要】：目的:分析骨髓增生异常综合征(MDS)患者外周血自然杀伤(NK)细胞亚型和功能分子的变化及其与骨髓恶性克隆的相关性,并对不同危险度进行分析,探讨NK细胞在MDS发病机制中的作用。方法:用流式细胞术检测2015-2016年间收治的35例MDS患者外周血NK细胞数量及其表面功能分子NKp30、NKp46、NKG2A的表达,并与34名正常对照比较;分析上述变化与骨髓原始细胞百分比、外周血中性粒细胞绝对值、血红蛋白量(Hb)相关性。结果:MDS组NK细胞、CD56~(dim)NK细胞的相对数量和绝对值均显著低于对照组(P0.05),而CD56~(bright) NK细胞数量高于对照组。分析NK细胞的亚型构成发现,MDS组NK细胞杀伤性亚型CD56~(dim) NK比例降低,与对照组相比差异有统计学意义。MDS组NK细胞表面活化性受体NKp30和NKp46的表达明显低于对照组(P0.05)。在MDS组中,高危组NK细胞、CD56~(dim)NK细胞明显低于低危组(P0.05)。MDS患者NK细胞数量与骨髓原始细胞比例(CD34~+%)呈负相关(r=-0.53),与中性粒细胞数(ANC)和血红蛋白含量(Hb)呈正相关(r=0.52);骨髓原始细胞数(CD34~+%)与NKp46的表达与呈负相关(r=-0.584),与NKG2A的表达呈正相关(r=0.523)。结论:MDS患者外周血NK细胞数量不足,亚群失调和功能下降可能导致疾病进展。
[Abstract]:Objective: To analyze the changes of natural killer (NK) cell subtypes and functional molecules in peripheral blood of patients with myelodysplastic syndrome (MDS) and their correlation with the malignant clone of bone marrow. Methods: The number of NK cells and the expression of NKp30, NKp46 and NKG2A in the peripheral blood of 35 patients with MDS from 2015 to 2016 were measured by flow cytometry, and compared with 34 normal controls, and the above-mentioned changes were compared with the percentage of the original cells of the bone marrow and the absolute value of the neutrophils in the peripheral blood. Hemoglobin amount (hb) correlation. Results: The relative number and absolute value of NK cells and CD56 ~ (dim) NK cells in the MDS group were significantly lower than that in the control group (P0.05), while the number of CD56 ~ (bright) NK cells was higher than that of the control group. It was found that the NK cell type CD56 ~ (dim) NK ratio in the MDS group was lower than that of the control group, and the difference of NK cell type CD56 ~ (dim) NK in the MDS group was statistically significant. The expression of NK cell surface activated receptor NKp30 and NKp46 in the MDS group was significantly lower than that in the control group (P0.05). In the MDS group, NK cells and CD56-(dim) NK cells were significantly lower in the high-risk group than in the low-risk group (P0.05). The number of NK cells in the MDS patients was negatively correlated with the proportion of the bone marrow (CD34 ~ +%) (r =-0.53) and positive correlation with the number of neutrophils (ANC) and hemoglobin (Hb) (r = 0.52); The number of bone marrow cells (CD34 ~ +%) was negatively correlated with the expression of NKp46 (r =-0.584) and positive correlation with the expression of NKG2A (r = 0.523). Conclusion: The number of NK cells in peripheral blood of MDS patients is insufficient, and the imbalance of subpopulation and function decrease may lead to disease progression.
【作者单位】：天津医科大学总医院血液科;
【基金】：国家自然科学基金(81170472 81400088) 天津市应用基础与前沿技术研究(14JCYBJC27200、09JCYBJC11200) 天津市抗癌重大专项攻关计划(12ZCDZSY17900)
【分类号】：R551.3

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