恶性浆膜腔积液出现噬血组织细胞临床意义初探

Exploration on the clinical implication of the bloodthirsty tissue cells appeared in malignant dropsy of serous cavity

目的通过报道出现噬血组织细胞的恶性浆膜腔积液患者的临床资料,结合检测白介素-6(IL-6)及肿瘤坏死因子α(TNF-α)水平,初步探讨恶性浆膜腔积液出现噬血组织细胞的临床意义。方法浆膜腔积液细胞分类按常规方法操作,涂片采用瑞氏-姬姆萨复合染液进行染色,油镜下分类200个-300个有核细胞,出现噬血组织细胞为阳性标本。采用双抗体夹心免疫酶标(ELISA)法,以30例出现噬血组织细胞的恶性浆膜腔积液为实验组,30例未出现噬血组织细胞的恶性浆膜腔积液为对照组,分别检测白介素-6(IL-6)及肿瘤坏死因子α(TNF-α)水平。结果 470例恶性浆膜腔积液中检出噬血组织细胞阳性者35例,占7.44%。噬血组织细胞阳性实验组患者浆膜腔积液IL-6水平为(213.51±99.92)pg/mL,高于噬血组织细胞阴性对照组患者的(131.95±62.17)pg/mL(P<0.01)。实验组患者浆膜腔积液TNF-α水平为(72.98±19.59)ng/L,高于对照组患者的(60.74±18.96)ng/L(P<0.01)。结论出现噬血组织细胞的恶性浆膜腔积液有高水平IL-6及TNF-α表达,说明本组病例在肿瘤细胞作用及自身免疫紊乱和持续感染作用下,使免疫细胞产生并释放大量细胞因子,这些细胞因子促使巨噬细胞过度活化,从而产生更多的细胞因子,导致浆膜腔积液细胞因子高水平表达和组织细胞噬血现象。

Objective To detect the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)combined with the clinical data of patients that who suffered with bloodthirsty tissue cells appeared in malignant dropsy of serous cavity,and to explore the clinical significance of bloodthirsty tissue cells appeared in malignant dropsy of serous cavity.Methods The cells in dropsy of serous cavity were classified according to the conventional method,then were stained on a smear by Wright's Giemsa staining dye complex.200 to 300 nucleated cells were counted and classified.All those specimen were judged to be positive which had hemophagocytic histiocytes.The levels of IL-6 and TNF-αwere detected by the method of ELISA in the experimental group of 30 positive cases of positive malignant dropsy of serous cavity and 30 negative cases as normal control.Results 35 cases of 470 malignant dropsy of serous cavity were hemophagocytic histiocytes positive(7.44%,35/470).The level of IL-6 in positive experimental group[(29.4±10.3)ng/L]was significantly higher than that in negative control group[(11.7±2.0)ng/L](P<0.01).The TNF-αlevel in experimental group[(16.4±6.2)ng/L]was higher than in negative control group[(20.5±10.9)ng/L](P<0.01).Conclusion Higher levels of IL-6 and TNF-αwere seen in malignant dropsy of serous cavity with hemophagocytic histiocytes,suggesting that the immune cells in these patients produce and release large numbers of cells factors under the interaction of tumor cells,autoimmune disorders and persistent infection.These cytokines induce excessive activation of macrophages,leading to higher levels of cell cytokine and hemophagocytic phenomenon in tissues.