Xie Yu, Bao Hong-Yu, Shi Xiao-Feng, Wang Jian-Ning, Han Xue, Meng Qing-Qi, Jiang Su-Yu, Zhang Lu, Zhang Liu-Bo, Chen Wan-Ru, Zou Xin-Di
Department of Hematology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
Department of Hematology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023;31(4):1061-1068. doi: 10.19746/j.cnki.issn.1009-2137.2023.04.021.
To study the role of cytokines and lymphocyte subsets in the diagnosis, prognosis and efficacy evaluation of DLBCL patients, and the effects of Tislelizumab on immune function and cytokines in DLBCL patients.
Twenty-three patients with newly diagnosed DLBCL were selected as DLBCL group and 34 patients with megaloblastic anemia as the control group. The levels of peripheral blood cytokines IL-2, IL-4, IL-6, IL-10, TNF- α and IFN-γ by ELISA method. The levels of peripheral blood CD3, CD4, CD8 T lymphocytes, B lymphocytes and NK cells， the ratio of CD4/CD8 were detected by flow cytometry. The levels of cytokins and lymphocyto subsets in DLBCL patients with different clinical data and different therapeutic effects were compared.
The levels of cytokines IL-2, IL-6 and IL-10 in DLBCL group were significantly higher than those in control group, but there was no significant correlation between cytokine levels and age and gender. The higher IPI score, higher Ann Arbor stage, B symptoms, higher β -MG, LDH and CRP levels, IL-6 and IL-10 levels were significantly higher, and IL-4 was also significantly higher in patients with high LDH levels. Compared with the ineffective group, the levels of IL-6 and IL-10 were significantly lower and the level of CD4 T cells and the ratio of CD4/CD8 was significantly higher in the effective group before therapy. The levels of IL-6, IL-10 and B lymphocytes in the effective group decreased significantly after therapy compared to those before therapy. After 4 cycles of therapy, the level of IL-2 and the ratio of CD4/CD8 in the Tislelizumab group were significantly higher than those in the non-Tislelizumab group, and the level of CD8 T cells was significantly lower than that in the non-Tislelizumab group(<0.05). The level of B lymphocytes in both the Tislelizumab group and the non-Tislelizumab group after therapy was significantly lower than that before therapy.
The expression of cytokines and lymphocyte subsets in peripheral blood of patients with DLBCL is abnormal, which is related to the severity, prognosis and therapeutic effect of the disease. Tislelizumab can improve the immune function of patients with DLBCL by affecting cytokines and lymphocyte subsets and strengthen anti-tumor immunity.
探讨细胞因子及淋巴细胞亚群在弥漫性大B细胞淋巴瘤（DLBCL）患者诊断、预后及疗效评估中的作用，以及替雷利珠单抗对DLBCL患者免疫功能和细胞因子的影响。
选取23例新诊断的DLBCL患者作为DLBCL组，34例巨幼细胞贫血患者作为对照组。采用酶联免疫吸附测定（ELISA）法检测外周血细胞因子白细胞介素-2（IL-2）、白细胞介素-4（IL-4）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）和干扰素-γ（IFN-γ）水平。采用流式细胞术检测外周血CD3、CD4、CD8 T淋巴细胞、B淋巴细胞和自然杀伤（NK）细胞水平及CD4/CD8比值。比较不同临床资料及不同治疗效果的DLBCL患者的细胞因子及淋巴细胞亚群水平。
DLBCL组IL-2、IL-6和IL-10水平显著高于对照组，但细胞因子水平与年龄、性别无显著相关性。国际预后指数（IPI）评分越高、Ann Arbor分期越高、有B症状、β2-微球蛋白（β-MG）、乳酸脱氢酶（LDH）和C反应蛋白（CRP）水平越高，IL-6和IL-10水平显著越高，LDH水平高的患者IL-4水平也显著升高。与无效组相比，治疗前有效组IL-6和IL-10水平显著降低，CD4 T细胞水平及CD4/CD8比值显著升高。治疗后有效组IL-6、IL-10和B淋巴细胞水平较治疗前显著降低。治疗4个周期后，替雷利珠单抗组IL-2水平及CD4/CD8比值显著高于非替雷利珠单抗组，CD8 T细胞水平显著低于非替雷利珠单抗组（P<0.05）。治疗后替雷利珠单抗组和非替雷利珠单抗组B淋巴细胞水平均较治疗前显著降低。
DLBCL患者外周血细胞因子及淋巴细胞亚群表达异常，与疾病的严重程度、预后及治疗效果相关。替雷利珠单抗可通过影响细胞因子及淋巴细胞亚群改善DLBCL患者免疫功能，增强抗肿瘤免疫。
