Th17细胞的异质性在骨髓增生异常肿瘤中的临床意义

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中图分类号：R551.3 文献标志码：A DOI：10.11958/20250670

Abstract： ObjectiveTo investigate the proportion Th17 cells，Th1-like Th17 cells and FoxP 3+ Th17 cells in bone marrow patientswithmyelodysplasticsyndrome（MDS），theexpresion interleukin-17A（IL-17A）inbonemarrow supernatantanditsclinical significance.MethodsFortyMDSpatients （MDSgroup）and18 patientswithnutritional anemia （control group）were selected.MDS patients were clasified into the low blast （MDS-LB）group （19cases）and the increasedblast （MDS-IB）group（21cases，including11cases type IB1and10cases typeIB2）basedonmorphological definition.TheMDSpatientswerescoredaccording totherevisedIntermationalPrognostic Scoring System（IPSS-R），with18 cases in the low-risk group （≤4.5） and 22 cases in the high-risk group （ > 4.5）.Flow cytometry was used to detect the proportion Th17 cells，Th1-like Th17 cells and FoxP 3+ Th17 cells in bone marrow the MDS group and the control group. Enzyme-linked immunosorbentassy（ELISA）wasused todetectthelevelIL-17Ainbone marrowsupermatant the abovesamples.ResultsThe proportion Th17celsand the level IL-17A were higher inpatients the MDS group than those in the control group （ P<0.05 ）.According to the median expressionlevel IL-17A，the MDS group was divided into the low-expression group （ <13.71ng/L ，20 cases） and the high-expression group （ ⩾ 13.71 ng/L，20 cases）. Compared with the low-expression group，there were higher proportion patients with blast cells <5% and low-risk patients （ P< 0.05）inthe high-expresson group.Compared with the IL-17Alow-expression group，the IL-17A high-expression group had a higher proportion patients with blast cells 4% and relatively low-risk patients （ P<0.05 ）.Comparedwith thelowrisk patients，high-risk patients hadalowerproportion Th17cels，IL-17AlevelsandTh1-likeTh17cels，andahigher proportion FoxP3+Th17 cells P<0.05） . Compared with the MDS-LB group，the MDS-IB group had a lower proportion Th17 cels，IL-17A levels and Th1-like Th17 cells，and a higher proportion FoxP3+Th17 cells （ P<0.05 ）. Conclusion TheproportionTh17celsandthe levelIL-17Aaresignificantly increased inMDSpatients.Thedecreasedproportion Th1-like Th17celsandthe increased proportionoxP3+Th17cels mayberelatedtothe increased proportion blast cells and higher risk stratification in patients.

Keywords：Th17 cells; heteroplasmy; interleukin-17; myelodysplastic neoplasms

骨髓增生异常肿瘤（myelodysplasticneoplasms，MDS）是一种起源于造血干细胞的异质性髓系肿瘤，以外周血细胞减少、骨髓无效造血、病态造血和高风险向急性髓系白血病（acutemyeloidleukemia，AML）转变为特征1。（剩余9519字）