慢性淋巴细胞白血病患者程序性死亡分子1/程序性死亡-配体1的表达及其临床意义

doi:10.3969/j.issn.1673-8640.2025.06.013

摘要/Abstract

摘要：

目的分析慢性淋巴细胞白血病（CLL）患者程序性死亡分子1（PD-1）/程序性死亡-配体1（PD-L1）的表达，及其与T淋巴细胞亚群的相关性，为靶向干预CLL提供参考。方法选取2020年4月—2023年6月金华市人民医院70例CLL患者（CLL组）和49例慢性粒细胞白血病患者（对照组）。根据Binet分级将CLL患者分为A组（24例）、B组（30例）和C组（16例）。检测所有患者PD-1 mRNA、PD-L1 mRNA和T淋巴细胞亚群。采用多因素Logistic回归分析评价CLL发生的影响因素。采用Pearson相关分析评价PD-1 mRNA、PD-L1 mRNA与T淋巴细胞亚群的相关性。结果 CLL组PD-1 mRNA、PD-L1 mRNA、辅助性T细胞（Th）9、Th17高于对照组（P<0.05），调节性T细胞（Treg）低于对照组（P<0.05）。A组、B组、C组PD-1 mRNA、PD-L1 mRNA、Th9、Th17水平均依次升高，Treg依次降低（P<0.05）。PD-1 mRNA、PD-L1 mRNA、Th9、Th17升高和Treg降低均是CLL发生的独立危险因素（P<0.05）。PD-1 mRNA、PD-L1 mRNA与Treg均呈负相关，与Th9、Th17均呈正相关（P<0.05）。结论 CLL患者PD-1 mRNA、PD-L1 mRNA均呈高表达。PD-1 mRNA、PD-L1 mRNA与CLL发生和病情密切相关，可为临床诊断提供参考。

关键词: 程序性死亡分子1, 程序性死亡-配体1, 慢性淋巴细胞白血病, T淋巴细胞亚群

Abstract:

Objective To investigate the expression of programmed death-1（PD-1）/programmed death-ligand 1（PD-L1） in chronic lymphocytic leukemia（CLL） patients and its correlation with T lymphocyte subsets，and to provide a reference for targeted intervention of CLL. Methods Totally，70 patients with CLL in Jinhua People's Hospital from April 2020 to June 2023 were enrolled as CLL group，and the patients were classified into Group A（24 cases），Group B（30 cases） and Group C（16 cases） according to Binet classification. Another 49 patients with chronic myelogenous leukemia in Jinhua People's Hospital were enrolled as control group. The PD-1 mRNA，PD-L1 mRNA and T lymphocyte subsets were determined. Multivariate Logistic regression analysis was used to investigate the relationship between CLL and PD-1 mRNA，PD-L1 mRNA. Pearson correlation analysis was used to evaluate the correlation between PD-1 mRNA，PD-L1 mRNA and T lymphocyte subsets. Results Compared with control group，the expressions of PD-1 mRNA，PD-L1 mRNA，T helper cell（Th）9 and Th17 in CLL group were increased（P<0.05），while the expression of Treg was decreased（P<0.05）. The levels of PD-1 mRNA，PD-L1 mRNA，Th9 and Th17 in Group A，B and C were increased，and Treg was decreased gradually（P<0.05）. PD-1 mRNA，PD-L1 mRNA，Th9 and Th17 increasing and Treg decreasing were independent influencing factors for CLL（P<0.05）. PD-1 mRNA，PD-L1 mRNA were negatively correlated with Treg, and PD-1 mRNA，PD-L1 mRNA were positively correlated with Th9 and Th17（P<0.05）. Conclusions The expressions of PD-1 mRNA，PD-L1 mRNA are increased in CCL，which can be used to predict CCL，providing a reference for clinical diagnosis.

Key words: Programmed death-1, Programmed death-ligand 1, Chronic lymphocytic leukemia, T lymphocyte subset

中图分类号:

R446.62

施方静, 胡姗姗, 罗信国, 朱艳, 俞方泉, 叶虹位. 慢性淋巴细胞白血病患者程序性死亡分子1/程序性死亡-配体1的表达及其临床意义[J]. 检验医学, 2025, 40(6): 592-595.

SHI Fangjing, HU Shanshan, LUO Xinguo, ZHU Yan, YU Fangquan, YE Hongwei. Expression of programmed death-1/programmed death-ligand 1 in chronic lymphocytic leukemia patients and its correlation with T lymphocyte subsets[J]. Laboratory Medicine, 2025, 40(6): 592-595.

图/表 5

参考文献 21

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基因名称	上游引物（5'~3'）	下游引物（5'~3'）
PD-1	TGGCATGTGCCAGATCATTTG	CCTTGCAGCTATTGTAGCAAACC
PD-L1	TGCTTAACGCCTTGGAAGA	CCAGCACACTTGTCCTTCA
GAPDH	GCACCGTCAAGGCTGAGAAC	TGGTGAAGACGCCAGTGGA

基因名称	上游引物（5'~3'）	下游引物（5'~3'）
PD-1	TGGCATGTGCCAGATCATTTG	CCTTGCAGCTATTGTAGCAAACC
PD-L1	TGCTTAACGCCTTGGAAGA	CCAGCACACTTGTCCTTCA
GAPDH	GCACCGTCAAGGCTGAGAAC	TGGTGAAGACGCCAGTGGA

组别	例数	PD-1 mRNA	PD-L1 mRNA	Treg/%	Th9/%	Th17/%
CLL组	70	1.75±0.40	1.64±0.38	4.25±1.02	1.30±0.35	2.08±0.48
对照组	79	1.04±0.24	1.05±0.23	7.54±2.21	0.68±0.23	1.04±0.33
t值		11.097	9.690	10.918	10.860	13.140
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	PD-1 mRNA	PD-L1 mRNA	Treg/%	Th9/%	Th17/%
CLL组	70	1.75±0.40	1.64±0.38	4.25±1.02	1.30±0.35	2.08±0.48
对照组	79	1.04±0.24	1.05±0.23	7.54±2.21	0.68±0.23	1.04±0.33
t值		11.097	9.690	10.918	10.860	13.140
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	PD-1 mRNA	PD-L1 mRNA	Treg/%	Th9/%	Th17/%
A组	24	1.41±0.35	1.35±0.33	6.14±1.59	1.04±0.26	1.64±0.39
B组	30	1.79±0.42	1.71±0.39	4.35±1.08	1.35±0.31	2.05±0.41
C组	16	2.11±0.45	2.01±0.43	3.21±0.57	1.76±0.41	2.57±0.50
t值		14.888	15.005	30.773	24.332	23.012
P值		<0.001	<0.001	<0.001	<0.001	<0.001