Correlations between CD4+CD25+Treg，sCD30 and Clinical Characteristics of Lymphoma and Their Value in Predicting Infection after Chemotherapy
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摘要:
目的 探讨淋巴瘤患者外周血CD4+CD25+调节性T细胞（CD4+CD25+Treg）、可溶性CD30（sCD30）表达及意义。 方法 选取2018年1月至2022年12月北京航天总医院收治的83例淋巴瘤患者作为研究对象，统计其外周血CD4+CD25+Treg、sCD30表达，Spearman分析外周血CD4+CD25+Treg、sCD30表达与骨髓浸润相关性，同时将研究对象根据利妥昔单抗化疗后有无感染分为感染组（n = 26）和非感染组（n = 57），比较2组外周血CD4+CD25+Treg、sCD30表达及差值，绘制受试者工作特征曲线（ROC）及曲线下面积（AUC）分析预测效能。 结果 研究组有骨髓浸润患者外周血CD4+CD25+Treg、sCD30表达高于无骨髓浸润患者（P < 0.05）；淋巴瘤患者外周血CD4+CD25+Treg、sCD30表达与骨髓浸润呈正相关（r=0.612、0.634，P < 0.05）；化疗后感染组外周血Tregs、sCD30表达高于非感染组，差值高于非感染组（P < 0.05）；ROC曲线显示，外周血CD4+CD25+Treg、sCD30差值联合预测淋巴瘤患者化疗后感染的AUC为0.916（0.834～0.965），优于单一预测。 结论 淋巴瘤外周血CD4+CD25+Treg、sCD30呈高表达，其值与骨髓浸润呈正相关，联检有助于提高化疗后感染预测效能，指导临床诊治。 Abstract:Objective To investigate the expression and significance of CD4+CD25+ regulatory T cells （CD4+CD25+Treg） and soluble CD30 （sCD30） in peripheral blood of lymphoma patients. Methods A total of 83 lymphoma patients admitted to Beijing Aerospace General Hospital from January 2018 to December 2022 were selected as the research subjects, and their peripheral blood CD4+CD25+Treg and sCD30 expressions were statistically analyzed. Spearman analysis was used to investigate the correlation between peripheral blood CD4+CD25+Treg and sCD30 expressions and bone marrow infiltration. At the same time, the research subjects were divided into an infection group （n = 26） and a non-infection group （n = 57） according to the presence or absence of infection after rituximab chemotherapy. The expressions and differences of peripheral blood CD4+CD25+Treg and sCD30 in the two groups were compared, and the receiver operating characteristic （ROC） curve and area under the curve （AUC） were used to analyze the predictive efficacy. Results The expression of CD4+CD25+Treg and sCD30 in peripheral blood of patients with bone marrow infiltration was higher than that of patients without bone marrow infiltration in the research group （P < 0.05）; the expression of CD4+CD25+Treg and sCD30 in peripheral blood of lymphoma patients was positively correlated with bone marrow infiltration （r = 0.612, 0.634, P < 0.05）; the expression of Tregs and sCD30 in peripheral blood of the infection group after chemotherapy was higher than that of the non-infection group, and the difference was higher than that of the non-infection group （P < 0.05）; the ROC curve showed that the combined prediction of the difference of CD4+CD25+Treg and sCD30 in peripheral blood for the infection after chemotherapy in lymphoma patients had an AUC of 0.916 （0.834-0.965）, which was superior to single prediction. Conclusion The high expression of CD4+CD25+Treg and sCD30 in peripheral blood of lymphoma patients is positively correlated with bone marrow infiltration. Combined testing can improve the predictive efficacy of infection after chemotherapy and guide clinical diagnosis and treatment. -
Key words:
- Lymphoma /
- Bone marrow infiltration /
- Chemotherapy /
- Infection /
- CD4+CD25+Treg /
- sCD30
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图 1 外周血CD4+CD25+Treg、sCD30单一及联合预测化疗后感染价值
Figure 1. Peripheral blood CD4+CD25+ Treg，sCD30 single and combined predictive value of post-chemotherapy infection
表 1 研究组不同临床特征外周血CD4+CD25+Treg、sCD30表达比较（$\bar x \pm s $）
Table 1. Comparison of peripheral blood CD4+CD25+Treg and sCD30 expression in the study groups with different clinical characteristics （$\bar x \pm s $）
临床特征 CD4+CD25+Treg（%） sCD30（kU/L） 性别 男性（n = 33） 2.50±0.41 159.23±19.46 女性（n = 50） 2.42±0.55 158.62±20.30 t 0.714 0.136 P 0.477 0.892 年龄（岁） <60（n = 43） 2.48±0.44 158.12±20.66 ≥60（n = 40） 2.42±0.51 159.66±21.17 t 0.575 0.335 P 0.567 0.738 体质量指数（Kg/m2） <18.5（n = 37） 2.42±0.50 158.12±20.91 18.5～24.0（n = 28） 2.47±0.44 159.04±20.25 ≥24.0（n = 18） 2.48±0.46 160.10±19.43 F 0.136 0.059 P 0.873 0.943 骨髓浸润 有（n = 18） 3.31±0.85 179.42±26.34 无（n = 65） 2.21±0.63 153.17±19.89 t 6.055 4.604 P <0.001* <0.001* 肿瘤分期 Ⅱ期（n = 38） 2.50±0.67 158.93±20.21 Ⅲ期（n = 45） 2.41±0.75 158.80±20.56 t 0.572 0.030 P 0.570 0.977 全身症状 有（n = 33） 2.41±0.66 158.79±21.15 无（n = 50） 2.48±0.73 158.91±20.78 t 0.444 0.026 P 0.658 0.980 *P < 0.05。 
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表 2 感染组和非感染组外周血CD4+CD25+Treg、sCD30表达比较（$\bar x \pm s $）
Table 2. Comparison of peripheral blood CD4+CD25+Treg，sCD30 expression between infection and non-infection groups （$ \bar x \pm s $）
项目 感染组（n = 26） 非感染组（n = 57） χ2 P CD4+CD25+Treg（%） 化疗前 2.50±0.66 2.43±0.70 0.430 0.668 化疗后 2.86±0.81 2.26±0.74 3.326 <0.001* 差值 0.36±0.11 0.17±0.06 10.177 <0.001* sCD30（kU/L） 化疗前 159.43±16.68 158.60±17.42 0.204 0.840 化疗后 172.22±23.34 152.77±18.89 4.035 <0.001* 差值 12.79±2.56 5.83±0.78 18.815 <0.001* 差值取绝对值；*P < 0.05。
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表 3 外周血CD4+CD25+Treg、sCD30单一及联合预测化疗后感染价值
Table 3. Peripheral blood CD4+CD25+ Treg，sCD30 single and combined predictive value of post-chemotherapy infection
项目 AUC（95%CI） 截断值 敏感度（%） 特异度（%） P 化疗后 CD4+CD25+Treg 0.725（0.616～0.817） >2.62% 61.54 78.95 <0.001* sCD30 0.766（0.660～0.852） >170.21 kU/L 61.54 91.23 <0.001* 两者联合 0.892（0.805～0.950） − 84.62 82.46 <0.001* 差值 CD4+CD25+Treg 0.809（0.708～0.887） >0.34 % 73.08 91.23 <0.001* sCD30 0.827（0.728～0.901） >12.08 kU/L 73.08 78.95 <0.001* 两者联合 0.916（0.834～0.965） − 84.62 85.96 <0.001* *P < 0.05。
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