支气管肺泡灌洗液T淋巴细胞亚群和细胞DNA含量分析对肺癌的诊断价值

Diagnostic value of T-lymphocyte subsets and cellular DNA contents in BALF for lung cancer

目的 探讨支气管肺泡灌洗液T淋巴细胞亚群和细胞DNA含量分析对肺癌的诊断价值。方法 用流式细胞仪对 3 0例肺癌和 12例肺良性病变患者的支气管肺泡灌洗液 (BALF)作T淋巴细胞亚群和细胞DNA含量分析 ,并与纤维支气管镜活检和刷检比较。结果 中央型肺癌组BALF中CD3 + (11.473± 3 .677) %、CD4+ (3 .660± 1.60 5 ) %、CD8+ (2 .3 49± 0 .880 ) %和CD4+ /CD8+ (1.411± 0 .3 0 9) ,周围型肺癌组BALF中CD3 + (12 .2 73± 4.42 5 ) %、CD4+ (2 .897±0 .695 ) %、CD8+ (2 .2 5 9± 0 .5 91) %和CD4+ /CD8+ (1.3 0 7± 0 .2 45 ) ;肺良性病变组BALFCD3 +(2 5 .0 78± 7.13 8) %、CD4+ (13 .2 44± 4.15 9) %、CD8+ (7.63 1± 3 .713 ) %和CD4+ /CD8+ (2 .2 78±0 .619) ,前两组显著低于后组 (肺良性病变组 ) (P <0 .0 0 1)。以异常二倍体为阳性标准 ,诊断肺癌的敏感性为 83 % ,特异性为 92 % ;中央型肺癌异常二倍体阳性率为 89% ,与活检 (95 % )和刷检(68% )比较 ,差异无显著性 (P >0 .5和P >0 .1) ;周围型肺癌异常二倍体阳性率为 82 % ,显著高于活检 (2 7% )和刷检 (2 7% )阳性率 (P均 <0 .0 5 )。结论 肺癌患者免疫功能低下 ,是肿瘤发生发展的原因之一 ,支气管肺泡灌洗液细胞DNA含量分析是诊断肺癌

Objective To evaluate the diagnostic value of flow cytometric T lymphocyte subsets and cellular DNA content analysis in bronchoalveolar lavage fluid (BALF) of lung cancer.Methods The T lymphocyte subsets and cellular DNA contents of BALF from 30 patients with lung cancer and 12 patients with benign pulmonary disorder were analyzed by flow cytometry. The diagnostic value of this method for lung cancer was compared with that of fiberoptic bronchoscopic biopsy and brushing.Results The percentage of CD3 +(11.473±3.677)%,CD4 +(3.660±1.605)%,CD8 +(2.349± 0.880)% and CD4 +/CD8 +(1.411±0.309)in BALF with central lung cancer,and the percentage of CD3 + (12.273 ±4.425)%,CD4 +(2.897±0.695)%,CD8 +(2.259±0.591)%,and CD4 +/CD8 +(1.307±0.245)in BALF with peripheral lung cancer were significantly lower than these of CD3 +(25.078± 7.138)%, CD4 +(13.244±4.159)%,CD8 +(7.631±3.713)% and CD4 +/CD8 +(2.278±0.619)in BALF with benign pulmonary disorder( P <0.001).The presence of aneuploidy was used as a diagnostic criterion,the sensitivity and specificity of DNA aneuploidy was 83% and 92%.The positive rate of aneuploidy in central lung cancer was 98%, and there was no statistical difference when compared with biopsy(95%) and brushing (68%).The positive rate of aneuploidy in peripheral lung cancer was 82%,significantly higher than biopsy(27%)( P <0.05) and brushing(27%)( P <0.05).Conclusions Immunofunction reduce may be a reason resulting in the occurring and development of lung cancer.The cellular DNA content analysis in BALF may be a valuable adjunctive method in the diagnosis of lung cancer,particularly in peripheral lung cancer.