恶性胸水和结核性胸水中活化T细胞、NK细胞和干扰素的比较分析

The Comparative Analysis of Active T Cells,Nature Killer Cells and Interferon-γ in Malignant and Tuberculous Pleural Effusions

目的比较结核性胸腔积液和恶性胸腔积液中活化T细胞和自然杀伤细胞(NK细胞)的分布情况以及γ-干扰素(γ-IFN)水平。方法应用流式细胞仪检测23例结核性胸腔积液与22例恶性胸腔积液中活化T细胞(CD3+HLA-DR+)或NK细胞(CD3-CD16+/CD56+)在胸水细胞中所占百分比,并通过ELISA方法检测不同性质胸水中的γ-IFN水平。结果结核性胸腔积液中活化T细胞比例及γ-IFN水平明显高于恶性胸腔积液,且活化T细胞比例与γ-IFN水平呈正相关。恶性胸腔积液中NK细胞百分比明显升高,但NK细胞百分比与γ-IFN水平无明显相关性。结核性胸腔积液中活化T细胞与NK细胞所占百分比的比值明显高于恶性胸腔积液。结论检测胸水中γ-IFN水平,活化T细胞或NK细胞所占百分比,尤其是胸水中活化T细胞与NK细胞所占百分比的比值可有助于临床对结核性胸腔积液和恶性胸腔积液进行鉴别诊断。

Objective To evaluate the distribution of active T cells and nature killer cells （ NK cells）, as well as the interferon-γ （γ-IFN） level in tuberculous pleural effusions and malignant ones. Methods The percentages of active T cells （ CD3^＋ HLA-DR^＋ ） or NK cells （CD3- CD16^＋/CD56^＋ ） in tuberculous pleural effusions （23 cases） and malignant ones （22 cases） were detected with flow cytometry. γ-IFN levels were also measured with Elisa method. Results Compared with malignant pleural effusions, tuberculous pleral exudates showed a higher percentage of active T cells and contained more γ-IFN. The percentage of active T cells was positively correlated with γ-IFN in tuberculous pleural effusions. There was a higher percentage of NK cells in malignant pleural exudates. However, The γ-IFN level was not correlated with percentage of NK cells in malignant pleural effusions. The ratio between the percentages of active T cells and NK cells was significantly higher in tuberculous pleural exudates when compared with malignant ones. Conclusion To detect γ-IFN level, also the percentages of active T cells and NK cells in pleural effusions, especially the ratio between the percentages of these two kinds of cells may provide a useful method to distinguish the malignant pleural effusions from tuberculous ones.