支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物检测在肺癌诊断中的应用价值

Application value of T lymphocyte subsets and tumor markers in bronchoalveolar lavage fluid in the diagnosis of lung cancer

目的探讨支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物检测在肺癌诊断中的应用价值。方法选取50例在我院就诊的肺癌患者为观察组,并选取同期在我院就诊的肺部良性病变患者30例为对照组。两组患者均予以行支气管肺泡灌洗,收集支气管肺泡灌洗液检测血清T淋巴细胞亚群、肿瘤标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)及鳞状细胞癌相关抗原(SCC)。观察并比较两组肺泡灌洗液T淋巴细胞亚群及肿瘤标志物水平的差异。结果观察组患者支气管肺泡灌洗液T淋巴细胞CD3^+、CD4^+水平明显低于对照组,CD8^+水平明显高于对照组,CD4^+/CD8^+水平明显低于对照组,差异有统计学意义(P<0.05或P<0.01);观察组患者支气管肺泡灌洗液肿瘤标志物CEA、CYFRA21-1、SCC水平均明显高于对照组,差异有统计学意义(P<0.01)。结论肺癌患者免疫功能低下,辅助性T淋巴细胞减少,细胞毒性T淋巴细胞增加,检测支气管肺泡灌洗液T淋巴细胞亚群及肿瘤标志物能为临床诊断肺癌提供依据。

Objective To explore the application value of T lymphocyte subsets and tumor markers in bronchoalveolar lavage fluid in the diagnosis of lung cancer. Methods 50 patients with lung cancer treated in our hospital were selected as observation group and 30 patients with benign lung lesions in our hospital in the same period were selected as control group. The patients in the two groups were treated withbronehoalveolar lavage, and thebronchoalveolar lavage fluid was collected to detect serum T lymphocyte subsets, tumor markers including carcinoembryonic antigen（CEA）, cytokeratin 19 fragment（CYFRA21-1） and squamous cell carcinoma related antigen（SCC）. The differences of T lymphocyte subsets and tumor markers in the bronchoalveolar lavage fluid between the two groups were observed and compared. Results The levels of CD3^＋ and CD4^＋ in T lymphocytes ofbronchoalveolar lavage fluid in the observation group were significantly lower than those in the control group. The level of CD8^＋ in the observation group was significantly higher than that in the control group, the level of CD4^＋/CD8^＋ was lower than that in control group, and the differences were significant between the two groups（P〈0.05 or P〈O.01）. The levels of the tumor markers including CEA, CYFRA21-1 and SCC in the bronchoalveolar lavage fluid of the observation group were significantly higher than those in the control group, and the differences were significant（P〈0.01）. Conclusion The lung cancer patients have low immune function, decreasedhelper T lymphocytes, increased cytotoxic T lymphocytes. Detection of T lymphocyte subsets and tumor mark- ers in bronchoalveolar lavage fluid can provide the basis for clinical diagnosis of lung cancer.