Objective: To observe the expression of helper T cells 17(Th17), interleukin 23 (IL-23) in peripheral blood in patients with acute myeloid leukemia (AML), to analyze the relationship between Th17, IL-23 in peripheral blood and immunophenotype.
Methods: 105 patients with AML in the hospital from January 2019 to January 2021 were prospectively selected as the research subjects, the expression of Th17 and IL-23 in peripheral blood of patients with AML was detected by flow cytometry; immunophenotype was detected and counted. The relationship between the expression of Th17, IL-23 in peripheral blood and immunophenotype of AML patients was analyzed. Draw ROC curve and analyze the predictive value of Th17 and IL-23 expression in peripheral blood to immunophenotype.
Results: The immunophenotype results of AML patients showed that myeloid antigen, lymphoid antigen and hematopoietic stem/progenitor cell marker antigen were positive expressed for various antigens in 105 AML patients, in myeloid antigens, CD13+ accounted for the highest proportion (93.33%), in lymphoid antigens, CD56+ accounted for the highest proportion (32.38%), and in hematopoietic stem/progenitor cell marker antigens, CD38+ accounted for the highest proportion (68.57%). The expression of Th17 in peripheral blood of AML patients with CD56+, CD7+, CD34+ and human leukocyte antigen DR+(HLA-DR+) were higher than that of AML patients with CD56-, CD7-, CD34-, HLA-DR-, the expression of IL-23 in peripheral blood of AML patients with CD56+, CD34+ and HLA-DR+ were higher than that of AML patients with CD56-, CD34-, HLA-DR-, the differences were statistically significant (P<0.05); compared the expression of Th17 and IL-23 in peripheral blood between other antibody positive and negative patients, there was no statistical significant difference (P>0.05). Logistic regression analysis showed that the high expression of Th17 in patients with AML was related to the positive expression of CD56, CD7, CD34 and HLA-DR in the detection of immunophenotype, the high expression of IL-23 was related to the positive expression of CD56, CD34 and HLA-DR in the detection of immunophenotype. The ROC curve showed that the AUC of expression levels of Th17 and IL-23 in peripheral blood alone and in combination for predicting CD56+, CD34+, HLA-DR+ and Th17 in peripheral blood for predicting CD7+ were mostly 0.5-0.7, which had certain predictive value, but the predictive performance was low.
Conclusion: Myeloid antigen, lymphoid antigen and hematopoietic hematopoietic stem/progenitor cell marker antigen are positive expressed for various antigens in AML patients, the high expression of Th17 in peripheral blood of AML patients is related to the positive expression of CD56, CD7, CD34 and HLA-DR in detection of immunophenotyping, the high expression of IL-23 is related to the positive expression of CD56, CD34 and HLA-DR in the detection of immunophenotype.
题目: 外周血Th17、IL-23的表达及其与急性髓细胞白血病患者免疫表型的关系分析.
目的: 观察急性髓细胞白血病（AML）患者外周血辅助性T细胞17（Th17）和白细胞介素23（IL-23）的表达，分析外周血Th17、IL-23与免疫表型的关系.
方法: 前瞻性选择2019年1月-2021年1月医院105例AML患者作为研究对象，经流式细胞术检测AML患者外周血Th17、IL-23的表达，检测并统计AML患者免疫表型；分析AML患者外周血Th17、IL-23表达与免疫表型的关系。绘制ROC曲线，分析外周血Th17、IL-23表达对免疫表型的预测价值.
结果: AML患者免疫表型检测结果显示，105例AML患者髓系抗原、淋系抗原、造血干/祖细胞标记抗原均有多种抗原呈阳性表达，髓系抗原中，CD13+占比最高（93.33%），淋系抗原中，CD56+占比最高（32.38%），造血干/祖细胞标记抗原中，CD38+占比最高（68.57%）。CD56+、CD7+、CD34+、人类白细胞抗原DR+(HLA-DR+)的AML患者外周血Th17表达高于CD56-、CD7-、CD34-、HLA-DR-的患者，CD56+、CD34+、HLA-DR+的AML患者外周血IL-23表达高于CD56-、CD34-、HLA-DR-的患者，差异有统计学意义（P＜0.05）；其他抗体阳性与阴性患者外周血Th17、IL-23表达比较差异无统计学意义（P＞0.05）。经Logistic回归分析显示，AML患者外周血Th17高表达与免疫表型检查中CD56、CD7、CD34、HLA-DR阳性表达有关，IL-23高表达与免疫表型检查中CD56、CD34、HLA-DR阳性表达有关。绘制ROC曲线发现，外周血Th17、IL-23表达水平单独及联合预测CD56+、CD34+、HLA-DR+的AUC及外周血Th17预测CD7+的AUC多数在0.5-0.7，有一定预测价值，但预测性能较低.
结论: AML患者髓系抗原、淋系抗原、造血干/祖细胞标记抗原均有多种抗原呈阳性表达，AML患者外周血Th17高表达与免疫表型检查中CD56、CD7、CD34、HLA-DR阳性表达有关，IL-23高表达与免疫表型检查中CD56、CD34、HLA-DR阳性表达有关.
Keywords: acute myeloid leukemia; helper T cells; immunophenotype; interleukin 23.