初诊骨髓增生异常综合征患者自然杀伤细胞水平低可能预示预后不良：一项回顾性队列研究
Low Levels of Natural Killer Cell in Newly Diagnosed Myelodysplastic Syndromes Patients May Confer Poor Prognosis: A Retrospective Cohort Study.
作者信息
Gong Shengping, Shi Cong
机构信息
Cancer Radiotherapy and Chemotherapy Center, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China.
Laboratory of Stem Cell Transplantation, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, 315000, People's Republic of China.
出版信息
Cancer Manag Res. 2024 Jul 3;16:753-760. doi: 10.2147/CMAR.S469393. eCollection 2024.
BACKGROUND
Immune imbalance appears to have a critical role in tumor growth according to emerging research. Peripheral lymphocyte subsets are considered to reflect the systemic immune response and clinical prognosis. The prognostic value of lymphocyte subpopulations in myelodysplastic syndrome (MDS) patients remains unclear.
METHODS
A total of 94 MDS patients were enrolled for the study. X-tile software was performed to determine the prognostic significance of various lymphocyte subpopulations, CD3, CD4, CD8, CD4/CD8 ratio, natural killer cell (NK) and CD19. Among them, the appropriate threshold of NK percent could be found only. Patients were divided into the high NK percent group and the low NK percent group. The prognostic significance was determined by univariate and multivariate Cox hazard models.
RESULTS
MDS patients with lower NK level had significantly shorter overall survival (OS). Based on univariate analysis, male gender ( = 0.030), lower HB (<10 g/dl, = 0.029), higher BM blast (>5%, < 0.0001), higher-risk IPSS-R cytogenetic ( = 0.032) and lower NK percent ( < 0.0001) were significantly associated with shorter OS. Multivariate Cox proportional hazards regression analysis indicated that low NK was also independent adverse prognostic factor for OS in MDS.
CONCLUSION
Decreased NK level predicts poor prognosis independent of the IPSS-R and provide a novel evaluation factor for MDS patients.
背景
根据最新研究，免疫失衡似乎在肿瘤生长中起关键作用。外周淋巴细胞亚群被认为可反映全身免疫反应和临床预后。骨髓增生异常综合征（MDS）患者淋巴细胞亚群的预后价值仍不明确。
方法
共纳入94例MDS患者进行研究。使用X-tile软件确定各种淋巴细胞亚群（CD3、CD4、CD8、CD4/CD8比值、自然杀伤细胞（NK）和CD19）的预后意义。其中，仅能找到NK百分比的合适阈值。患者被分为高NK百分比组和低NK百分比组。通过单因素和多因素Cox风险模型确定预后意义。
结果
NK水平较低的MDS患者总生存期（OS）明显较短。基于单因素分析，男性（P = 0.030）、较低的血红蛋白（<10 g/dl，P = 0.029）、较高的骨髓原始细胞比例（>5%，P < 0.0001）、较高风险的IPSS-R细胞遗传学（P = 0.032）和较低的NK百分比（P < 0.0001）与较短的OS显著相关。多因素Cox比例风险回归分析表明，低NK也是MDS患者OS的独立不良预后因素。
结论
NK水平降低预示着不良预后，独立于IPSS-R，并为MDS患者提供了一个新的评估因素。
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