Value for detection of peripheral blood T-lymphocyte subsets before and after splenectomy in patients with immune thrombocytopenic purpura

Objective To investigate the T-lymphocyte subsets and CD56+ NK T cells changes of peripheral blood before and after splenectomy,and the relationship between these variables and hematological outcomes in patients with immune thrombocytopenic purpura (ITP).Methods Using flow cytometry technique,the percentages of T-lymphocyte subsets (including CD3+,CD3+CD4+ and CD3+CD8+) and CD56+ NK cells of peripheral blood were detected 7 days before and after laparoscopic splenectomy in 34 patients with ITP.The patients were then divided into splenectomy effective group (group A,22 cases) and splenectomy ineffective group (group B,12 cases) according to their hematological outcomes.The differences of the percentages of T-lymphocyte subsets and CD56+ NK cells,and CD4+/CD8+ ratio between two groups,as well as the changes of these variables before and after operation in each group,were analyzed by the software of SPSS 13.0 for windows.Results The percentages of CD3+CD4+ cells before operation were (32.83±8.07)% in group A and (26.23±6.17)% in group B (P=0.045).The CD4+/CD8+ ratios before operation were (1.30±0.51) in group A and (0.84±0.42) in group B (P=0.022).There were no significant differences of other preoperative or postoperative variables between two groups.The percentages of CD3+ cells before and after operation were (65.51±4.54)% and (60.38±12.97)% in group B,respectively (P=0.017).And the percentages of CD3+CD8+ cells before and after operation were (37.27±12.47)% and (32.96±13.18)% in group B,respectively (P=0.025).There were nosignificant differences of other variables between pre-operation and post-operation in each group.Conclusions There is different cellular immunopathogenesis in ITP patients with different responses to splenectomy.Preoperative detection of the percentages of CD3+CD4+ cells and CD4+/CD8+ ratio in peripheral blood is helpful to predict the outcome of operation.