摘要目的:探讨髓系来源抑制细胞(MDSCs)在多发性骨髓瘤(MM)患者中的外周血表达与临床效果。方法:选取2015年10月至2017年6月丽水市人民医院血液科收治的40例初治型MM患者为MM组，男27例，女13例，年龄(58±8)岁，年龄范围为48～76岁。另外选取40例健康体检者作为健康对照组，其中男25例，女15例，年龄(56±11)岁，年龄范围为45～74岁。MM组患者入院后均采用一线治疗方案，通过流式细胞术检测外周血MDSCs、肿瘤相关巨噬细胞(TAM)及调节性T细胞(Tregs)表达，采用ELISA法检测患者外周血血清中的白细胞介素-6(IL-6)水平。结果:治疗前MM组患者MDSCs[(8.40±2.15)%]、TAM[(6.33±1.34)%]、Tregs[(9.25±3.68)%]、IL-6[(13.40±0.80)pg/ml]均高于健康体检组[(0.47±0.26)%、(1.80±0.89)%、(2.42±3.31)%、(2.45±0.24)pg/ml]，差异有统计学意义( P<0.05)。治疗后，MM组患者MDSCs[(0.94±0.41)%]、TAM[(2.64±1.12)%]、Tregs[(1.92±1.51)%]、IL-6[(5.62±0.56)pg/ml]显著低于治疗前，差异有统计学意义( P<0.05)。 结论:MDSCs在MM不同阶段呈规律性表达，与TAM、Tregs表达趋势一致，提示在MM发生、发展过程中MDSCs可能参与了骨髓瘤细胞的免疫耐受及肿瘤逃逸机制。

abstractsObjective:To investigate the expression and clinical effect of myeloid-derived suppressor cells(MDSCs)in peripheral blood of patients with multiple myeloma(MM).Methods:From October 2015 to June 2017, 40 newly treated MM patients in the Hematology Department of Lishui people′s hospital were selected as the MM group, 27 males and 13 females, aged(58±8)years and ranging from 48 to 76 years.In addition, 40 healthy people were selected as the control group, including 25 males and 15 females, aged(56±11)years, ranging from 45 to 74 years.In MM group, the first-line treatment was used after admission.The expression of MDSCs, TAM and Tregs were detected by flow cytometry.The level of IL-6 was detected by ELISA.Results:Before treatment, MDSCs[(8.40±2.15)%], TAM[(6.33±1.34)%], Tregs[(9.25±3.68)%], IL-6[(13.40±0.80)pg/ml]in MM group were higher than those in healthy physical examination group[(0.47±0.26)%, (1.80±0.89)%, (2.42±3.31)%, (2.45±0.24)pg/ml], the difference was statistically significant( P<0.05). After treatment, MDSCs[(0.94±0.41)%], TAM[(2.64±1.12)%], Tregs[(1.92±1.51)%], IL-6[(5.62±0.56)pg/ml]in MM group were significantly lower than those before treatment( P<0.05). Conclusion:MDSCs expressed regularly in different stages of MM, which was consistent with the expression trend of TAM and Tregs.