血液系统恶性肿瘤细胞共刺激分子的检测及其临床意义

目的　探讨共刺激分子B7 1(CD80 )在血液系统恶性肿瘤发病学及免疫基因治疗中的重要作用。方法　应用免疫荧光法检测了 76例恶性血液病患者共刺激分子B7 1及MHCⅠ、MHCⅡDR分子的表达 ,并与自体瘤苗主动免疫治疗的疗效进行了相关分析。结果　所有患者MHCⅠ类分子表达均阳性 (10 0 % ) ,MHCⅡDR分子表达阳性率为95 %。B7 1在急性单核细胞白血病 (M5 )及多发性骨髓瘤 (MM)表达阳性率较高 ,分别为 6 9%和 10 0 % ,而在粒细胞起源的白血病几乎无表达。这与自体瘤苗免疫治疗的临床疗效基本符合 ,即疗效好的M5和MM病例 ,其B7 1表达均阳性 ,而B7 1阴性者几乎无疗效。结论　缺乏共刺激分子 (如B7 1)是血液肿瘤细胞逃避宿主免疫监视的重要原因 ,可能是人类血液肿瘤的发病机理之一 ;B7 1介导的免疫基因治疗将成为治疗人类血液系统恶性肿瘤尤其是急性白血病的一种有效方法 ,具有重要的临床应用价值

Detection of costimulatory molecules in hematologic malignant tumors and its clinical significance

Objective To explore the significance of costimulatory molecule B7-1 (CD80) and MHC molecules in the pathogenesis of hematologic malignant tumors and in the immuno-genetic therapy. Methods The expression of costimulatory molecule B7-1 and MHCⅠ, and MHC ⅡDR molecules was detected by immunofluoressence in 76 cases of hematologic malignant tumors. Moreover, it was compared with the effects of active immunotherapy by the auto vaccine. Results MHC class Ⅰ molecule was positive (100%) in all cases and the positive rate of MHC ⅡDR molecule was 95%. The rate of B7-1 molecule was higher in acute mononcytic leukemia (M5) and multiple myeloma (MM) (69% and 100%, respectively). However, it was lower in myeloid leukemia. Furthermore,it supported the clinical effects of recent active specific immunotherapy with an auto vaccine. In the cases which responded well to immunotherapy such as M5 and MM, B7-1 was positive. Conclusion The deficiency of costimulatory molecules (such as B7-1) is an important cause for leukemic tumor cells evading host immunosurveillance and may be one of the mechanisms of human hematologic malignant tumors. It is also indicated that immuno-genetic therapy mediated by B7-1 may be an effective way against human hematologic malignant tumors and has a significant clinical value.