中文摘要：

目地 检测弥漫大B细胞淋巴瘤（DLBCL）患者两种预后亚型（生发中心型和非生发中心型）不同治疗阶段的T细胞亚群分布，评估患者的T细胞免疫功能状态。方法 采用流式细胞术（FCM）检测34例DLBCL患者发病初、化疗期间、疗程结束后外周血中的CD＋3、CD＋4、CD＋8和CD＋4 CD＋25 T细胞的分布情况。以16名健康人外周血作为对照。结果 DLBCL两种预后亚型患者化疗前外周血中CD＋4 T细胞比例和CD4／CD8比值分别为（32.27±2.00）%和（0.81±0.39），明显低于正常水平；CD＋8 T细胞、CD＋4 CD＋25 T细胞比例分别为（40.80±6.23）%和（5.68±5.45）%，明显增高。而CD＋3 T细胞比例则在整个治疗过程中保持稳定状态，与正常水平比较差异均无统计学意义（均P＞0.05）。化疗3个周期后CD＋8 T细胞逐渐减少，而CD＋4、CD＋4 CD＋25 T细胞、CD4／CD8比值则明显上升，至化疗6个周期结束后除了CD＋4 CD＋25 T细胞仍明显高于正常及化疗前水平外，余各项指标与正常水平比较差异均无统计学意义（均P＞0.05）。至化疗结束3个月后，CD＋4 CD＋25 T细胞逐渐下降至接近正常，除了化疗前生发中心型CD＋3 和CD＋8 T细胞比例[分别为（74.83±3.59）%和（40.80±6.23）%]高于非生发中心型[分别为（68.26±3.56）%和（33.76±5.46）%]，不同治疗时期DLBCL患者两种预后亚型间各项指标差异均无统计学意义（t值分别为2.039、2.419，P值分别为0.041、0.018）。不同时期DLBCL患者两种预后亚型间各指标差异均无统计学意义（均P＞0.05）。结论 不同基因亚型DLBCL患者不同治疗时期均存在不同程度的细胞免疫受抑，动态监测T细胞亚群的变化可以实时了解患者的T细胞免疫功能状况。

英文摘要：

Objective To detect the distribution of T lymphocyte subpopulations at different stages of treatment in diffuse large B-cell lymphoma （DLBCL） patients with distinct gene subtypes （GCB and non-GCB）, thereby to evaluate the status of T-cell immunity. Methods Expression of CD＋3, CD＋4, CD＋8, CD＋4 CD＋25 on T lymphocytes of 34 DLBCL patients was detected by flow cytometry （FCM） before, during, and after chemotherapy. 16 normal individuals served as the controls. Results The proportion of CD＋4 T cells and the ratio of CD＋4/CD＋8 before chemotherapy were （32.27±2.00） % and （0.81±0.39） %, respectively, and were lower than those in the healthy controls. In addition, CD＋8 and CD＋4 CD＋25 T cells were （40.8±6.23） % and （5.68±5.45） %, higher than the controls. Further, CD＋3 T cells kept constant through the different stages of treatment, with no statistically significant difference when compared to the normal level. CD＋8 T cells were decreased gradually, while CD＋4 and CD＋4 CD＋25 T cells, and the ratio of CD＋4/CD＋8 were raised dramatically. Except the CD＋4 CD＋25, all T cell subpopulations came back to the basal level after sixth cycles of chemotherapy. The difference of T cell subpopulations between GCB and non-GCB DLBCL patients was not statistically significant, except the respective proportions of CD＋3 and CD＋8 T cells （74.83±3.59） % and （40.8±6.23） % in GCB DLBCL patients before chemotherapy were higher than those in the non-GCB DLBCL patients [（68.26±3.56） % and （33.76±5.46） %] （t = 2.039, 2.419, P = 0.041, 0.018）. CD＋4 CD＋25 T cells were decreased gradually and restored to the baseline 3 months after the last cycle of chemotherapy, while they were obviously lower in the GCB DLBCL patients （t = 2.481, P = 0.035）. Conclusion There is cellular immunosuppression to some extent at different stages of treatment in DLBCL patients with distinct gene subtypes. It is thus necessary to monitor the changes in T lymphocyte subpo