流式细胞术检测甲状腺癌针吸组织中T淋巴细胞亚群及吞噬细胞糖蛋白的临床意义

探讨甲状腺癌组织中Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８）及吞噬细胞糖蛋白（ＣＤ４４）表达的规律，并研究免疫状态与肿瘤转移的关系，通过流式细胞免疫法对１３例甲状腺癌细针穿刺标本进行测定，并与甲状腺良性肿块对照。结果表明：甲状腺癌组ＣＤ３、ＣＤ４、ＣＤ８及ＣＤ４４阳性细胞较良性组均有明显变化，其中ＣＤ３、ＣＤ４阳性细胞明显下降（Ｐ＜０．０１），ＣＤ８阳性细胞明显增加（Ｐ＜０．０１），ＣＤ４／ＣＤ８比值明显降低（Ｐ＜０．０１），有转移者其变化更明显。ＣＤ４４阳性细胞在甲状腺癌组明显高于良性肿块组（Ｐ＜０．０１），且与转移有关。提示Ｔ淋巴细胞亚群紊乱使肿瘤细胞摆脱免疫监视而易于转移。本法操作简便，术前进行检查，可对患者免疫状态、肿瘤诊断、病程进展的估计及术前决策有帮助。     

原发性肝癌患者T淋巴细胞亚群及功能变化在肿瘤复发中的临？…

目的 评价原发性肝癌（ＰＨＣ）患者Ｔ淋巴细胞亚群及功能变化在癌复发中的临床意义。方法 应用细胞增殖试验。免疫组化分析和细胞毒活性测定等方法对６０例ＰＨＣ患者手术前后外周血Ｔ细胞亚群及功能变化进行动态观察。结果 术前带瘤期ＰＨＣ患者ＣＤ３，ＣＤ４细胞下降，ＣＤ８细胞增高，且ＣＤ４／ＣＤ８比例倒置，Ｔ细胞活化增殖功能和抗肿瘤杀伤作用亦明显削弱，结论 ＰＨＣ患者术后癌复发与细胞免疫功能低下有关，在Ｔ细胞     

流式细胞术检测甲状腺癌针及吸组织中T淋巴细胞亚群及 …

探讨甲状腺癌组织中Ｔ淋巴细胞亚群（ＣＤ３、ＣＤ４、ＣＤ８）及吞噬细胞糖蛋白（ＴＤ４４）表达的规律，并研究免疫状态与肿瘤转移的关系，通过流式细胞免疫法对１３例甲状腺癌细针穿刺标本进行测定，并与甲状腺良性肿块对照。结果表明：甲状腺癌组ＣＤ３、ＣＤ４、ＣＤ８及ＣＤ４４阳性细胞较良好性组均有显著性变化，其中ＣＤ３、ＣＤ４阳性细胞明显下降（Ｐ〈０．０１），ＣＤ８阳性细胞显著增加（Ｐ〈０．０１），ＣＤ４／ＣＤ     

重症巨细胞病毒感染和急性排斥肾移植受者T淋巴细胞亚群的动态变化

目的：探讨肾移植受者外周血Ｔ淋巴细胞亚群与发生重症巨细胞病毒（ＣＭＶ）感染和急性排斥反应（ＡＲ）之间的关系。方法：采用ＣＯＵＬＴＥＲ公司生产的鼠抗人Ｔ淋巴细胞亚群单克隆抗体ＯＫＴ系列及ＥＬＩＴＥ型流式细胞仪对２３例重症ＣＭＶ感染者、８例ＡＲ患者和２０例正常肾移植者的外周血Ｔ淋巴细胞亚群进行动态测定。结果：术后无ＡＲ者与ＡＲ者、排斥反应缓解者与未缓解者,其ＣＤ４／ＣＤ８比值变化差异有显著性意义（Ｐ〈     

氨茶碱对支气管哮喘外周血T淋巴细胞亚群比值影响的临床观察

目的：探讨氨茶碱对支气管哮喘外周血Ｔ淋巴细胞亚群比值有何影响，对支气管哮喘的治疗起何作用。方法：选择支气管哮喘病人３６例分成两组，分别给予氨茶碱和未用氨茶碱类止喘药，并在治疗前后进行Ｔ淋巴细胞亚群的测定。结果：用药前两组ＣＤ８＾＋、ＣＤ４＾＋／ＣＤ８＾＋比值无显著性差异（Ｐ〉０．０１）。用药后，氨茶碱组ＣＤ８＾＋增高，ＣＤ４＾＋／ＣＤ８＾＋比值恢复正常（Ｐ〉０．０１）；而未用氨茶碱组ＣＤ８＾＋、Ｃ     

移植肾组织CD4^＋,CD8^＋细胞检测及其临床意义

探讨移植肾组织内ＣＤ４＋、ＣＤ８＋变化的临床意义。方法对４８例移植肾组织内ＣＤ４＋、ＣＤ８＋细胞进行了临床监测。结果移植肾急性排斥组ＣＤ４＋ＣＤ８＋细胞明显高于对照组、稳定组、急性肾小管坏死和环孢素中毒组；肾组织内ＣＤ４＋、ＣＤ８＋细胞呈弥漫分布；ＣＤ４＋／ＣＤ８＋比值＞１．３，对激素冲击治疗有效，反之无效。结论移植肾组织活检同时监测组织内Ｔ淋巴细胞亚群变化在肾移植患者急性排斥的诊断和治疗方面具有极其重要的临床意义     

骨肿瘤,骨转移癌患者免疫功能变化及临床意义

对６２例骨肿瘤、骨转移癌患者外周血中Ｔ淋巴细胞亚群（ＰＴＬＳ）、淋巴细胞转化率（ＬＴＲ）的变化进行研究。结果显示：骨肿瘤患者外周血中全Ｔ淋巴细胞（ＣＤ３＋）及辅助／诱导性Ｔ细胞（ＣＤ４＋）较对照组明显降低，抑制／细胞毒性Ｔ细胞（ＣＤ８＋）无明显变化，ＣＤ４＋／ＣＤ８＋比率显著下降，以恶性骨肿瘤组降低最明显。骨转移癌患者呈类似变化。淋巴细胞转化率，骨肿瘤、骨转移癌组显著低于正常组。证明患者的免疫功能变化与骨肿瘤的存在、发展密切相关。此外，观察了恶性骨肿瘤患者手术前后ＰＴＬＳ变化，术后ＣＤ３＋、ＣＤ４＋、ＣＤ８＋恢复正常水平，ＣＤ４＋／ＣＤ８＋比率升高。随访观察结果亦表明ＬＴＲ、ＣＤ３＋、ＣＤ４＋持续降低，ＣＤ４＋／ＣＤ８＋比率倒置的患者预后较差。提示动态观察恶性骨肿瘤患者外周血中Ｔ淋巴细胞及其亚群、淋巴细胞转化率的变化有助于判断预后。     

胃癌患者手术前后T细胞亚群的变化

目的 观察胃癌患者手术前后Ｔ细胞亚群的变化。方法 采用单克隆抗体酶标法对３０例胃癌患者手术前后不同时期的Ｔ细胞亚群即表达于所有Ｔ细胞的表面分子（ＣＤ３）、辅助Ｔ细胞的表面分子（ＣＤ４）、抑制Ｔ细胞的表面分子（ＣＤ８）进行动态检测。结果（１）胃癌组ＣＤ３、ＣＤ４阳性细胞数和ＣＤ４／ＣＤ８比值明显低于正常对照组，ＣＤ８阳性细胞数高于正常对照组。（２）手术可引起Ｔ细胞亚群变化，这种变化是可逆的．（３）根     

外周血淋巴细胞穿孔素的表达及在肾移植排斥与耐受中的临床意义

目的 测定细胞内穿孔素（Ｐ＋）及细胞表面怕的表达,探讨与移植肾急性排斥和长期存活的关系。方法 用流式细胞仪测定２２例口才外周血细胞毒Ｔ淋巴细胞和自然杀伤细胞亚群穿孔素的表达。结果 排斥组淋巴细胞穿孔素的表达高于非排斥组,排瓜反应与ＣＤ４＾＋Ｐ＾＋下调和ＣＤ８＾＋Ｐ＾＋上调有关。冲击治疗可引起Ｐ＾＋Ｔ细胞亚群和ＣＤ５６＾＋ＮＫ细胞的降低。ＣＤ４＾＋Ｐ＾＋及ＣＤ８＾＋Ｐ＾＋细胞的下调和ＣＤ５６＾＋Ｐ上     

同种带瓣主动脉和肺动脉移植免疫排斥反应的研究

目的 探讨同种带瓣管道移植对宿主免疫状态的影响以及排斥反应对移植物的作用。方法 应用同种异体带瓣主动脉或肺动脉重建右室流出道,并随机分为Ａ组（移植组）,Ｂ组（免疫抑制组）和Ｃ组（对照组）。分别在术后１,２,３,４周收集外周血标本,应用流式细胞仪测定Ｂ细胞及Ｔ淋巴细胞亚群的变化,应用酶联法测定血清中ＩＬ－２含量。结果 移植１周后外周血中Ｔ淋巴细胞数明显增高,ＣＤ＾＋４阳性率,ＣＤ＾＋４／ＣＤ＾＋８比     

Apoptosis and CD8 and CD54 cell expression in rat small bowel transplantation

The importance of activated CD8 cells expressing IL-2R in small bowel and other organ rejection has been reported. Some authors even consider that a positive correlation might be demonstrated between the number of apoptotic enterocytes and the degree of graft rejection. In addition, moderate to intense activation of endothelial molecules in small bowel allograft in rats has been reported in chronic rejection. The aim of the present paper is to ascertain, in a heterotopic small bowel transplantation (HSBT) in rats, whether CD3, CD4, CD8, and CD54 cell expression in the allograft infiltrates shows some relationship with allograft enterocyte apoptosis when rejection is present. Wistar Furth male rats were allotted to two groups: group A was the control group without transplantation; group B received a heterotopic small bowel allograft from Fisher rats and an im dose of FK506 (0.25 mg/kg/day). A significant increase of CD8, CD54 cell receptor expression, and apoptosis in the group undergoing HSBT showed rejection. No significant differences have been observed in the variables under study between the control and HSBT without rejection groups or in CD3 and CD4 among the three groups. We observed a significant correlation between apoptosis and rejection, between CD8 and CD54 with apoptosis and with rejection, and between CD8 and CD54. This indicates that the activation of endothelial molecules and cells may play an important role in established HSBT chronic rejection. We consider that this study may contribute to the knowledge of small bowel allograft chronic rejection and its immunomodulation.     

大鼠小肠移植术后浸润移植小肠的T细胞动态研究

以远交系大鼠制作异位小肠移植模型，利用图像分析技术对浸润移植小肠的T淋巴细胞亚群进行连续定量测定，并与终期组织病理检查做比较，分析T淋巴细胞在排斥反应中的作用。结果表明未使用免疫抑制治疗的大鼠在术后其移植物均出现OX8＋细胞浸润增多，而使用环孢素A的大鼠其OX8＋和W3／13＋细胞浸润逐渐减少；术后7～10天各组大鼠小肠移植物W3／25＋细胞均呈上升趋势。本研究说明OX8＋细胞亚群在排斥反应中起重要作用，其浸润增多与移植物局部免疫损伤的形成有密切关系。     

小肠移植后亚临床排斥反应的临床病理研究一例

目的 探讨小肠移植后亚临床型细胞性排斥反应(SCR)的临床表现、肠镜下改变和病理特点.方法 小肠移植1例,受者为女性,34岁,供者为男性.应用抗CD52单克隆抗体行诱导治疗,术后单用他克莫司(Tac)、无皮质激素的维持治疗方案.怀疑发生可疑排斥反应(IND)级至I级排斥反应时,提高血Tac浓度,行短程小剂量皮质激素治疗,排斥反应控制不佳时,则行甲泼尼龙冲击治疗;发生中度排斥反应时提高血Tac浓度,给予甲泼尼龙2 g,随后应用皮质激素递减方案.术后头2个月内,每周行2次肠镜和病理学检查,之后频次减为1次/周.结果 至随访结束患者已存活19个月(611 d),期间共发生有临床症状的急性排斥反应6次,亚临床排斥反应3次.3次亚临床排斥反应时,2次肠镜下未见明显改变,1次表现为斑点状的充血、水肿,放大肠镜下绒毛数量轻度减少.3次亚临床排斥反应的病理检查中,1次以黏膜上皮剥脱为主,隐窝上皮损伤较轻,组织学改变符合轻度急性排斥反应;而另2次以隐窝上皮的损伤为主,为可疑急性排斥反应.结论 SCR可能是临床排斥反应的早期阶段,无明显临床症状,肠镜下改变不明显,诊断主要依靠病理学检查,但必须排除移植肠血管病变、肠梗阻、各类炎症等术后并发症.

Abstract：

Objective To investigate the clinical presentation, endoscopy and pathological features of subclinical cellular rejection (SCR) of small bowel allotransplantation. Methods Three times of SCR in a patient after isolated small bowel transplantation were studied by endoscopy and microscopy, and the clinical data and literature were reviewed. Results SCR was an unusual type of acute rejection after small bowel transplantation. SCR showed low-grade morphological changes of acute rejection, and may be relived after low-dose steroid or bolus steroid was given. Conclusion The causes of SCR are not clear now. SCR may be the early stage of clinical acute rejections, and may be correlated with unexpected high grade acute rejection, and chronic loss function of graft. The biopsy through ileoscopy is a "golden standard" of diagnosis of SCR in small bowel transplantation.However, the vessel lesions of graft, ileus, and inflammation should be excluded before diagnosis.     

小肠移植后亚临床排斥反应的临床病理研究一例

目的 探讨小肠移植后亚临床型细胞性排斥反应(SCR)的临床表现、肠镜下改变和病理特点.方法 小肠移植1例,受者为女性,34岁,供者为男性.应用抗CD52单克隆抗体行诱导治疗,术后单用他克莫司(Tac)、无皮质激素的维持治疗方案.怀疑发生可疑排斥反应(IND)级至I级排斥反应时,提高血Tac浓度,行短程小剂量皮质激素治疗,排斥反应控制不佳时,则行甲泼尼龙冲击治疗;发生中度排斥反应时提高血Tac浓度,给予甲泼尼龙2 g,随后应用皮质激素递减方案.术后头2个月内,每周行2次肠镜和病理学检查,之后频次减为1次/周.结果 至随访结束患者已存活19个月(611 d),期间共发生有临床症状的急性排斥反应6次,亚临床排斥反应3次.3次亚临床排斥反应时,2次肠镜下未见明显改变,1次表现为斑点状的充血、水肿,放大肠镜下绒毛数量轻度减少.3次亚临床排斥反应的病理检查中,1次以黏膜上皮剥脱为主,隐窝上皮损伤较轻,组织学改变符合轻度急性排斥反应;而另2次以隐窝上皮的损伤为主,为可疑急性排斥反应.结论 SCR可能是临床排斥反应的早期阶段,无明显临床症状,肠镜下改变不明显,诊断主要依靠病理学检查,但必须排除移植肠血管病变、肠梗阻、各类炎症等术后并发症.     

小肠移植后亚临床排斥反应的临床病理研究一例

目的 探讨小肠移植后亚临床型细胞性排斥反应(SCR)的临床表现、肠镜下改变和病理特点.方法 小肠移植1例,受者为女性,34岁,供者为男性.应用抗CD52单克隆抗体行诱导治疗,术后单用他克莫司(Tac)、无皮质激素的维持治疗方案.怀疑发生可疑排斥反应(IND)级至I级排斥反应时,提高血Tac浓度,行短程小剂量皮质激素治疗,排斥反应控制不佳时,则行甲泼尼龙冲击治疗;发生中度排斥反应时提高血Tac浓度,给予甲泼尼龙2 g,随后应用皮质激素递减方案.术后头2个月内,每周行2次肠镜和病理学检查,之后频次减为1次/周.结果 至随访结束患者已存活19个月(611 d),期间共发生有临床症状的急性排斥反应6次,亚临床排斥反应3次.3次亚临床排斥反应时,2次肠镜下未见明显改变,1次表现为斑点状的充血、水肿,放大肠镜下绒毛数量轻度减少.3次亚临床排斥反应的病理检查中,1次以黏膜上皮剥脱为主,隐窝上皮损伤较轻,组织学改变符合轻度急性排斥反应;而另2次以隐窝上皮的损伤为主,为可疑急性排斥反应.结论 SCR可能是临床排斥反应的早期阶段,无明显临床症状,肠镜下改变不明显,诊断主要依靠病理学检查,但必须排除移植肠血管病变、肠梗阻、各类炎症等术后并发症.     

小肠移植后亚临床排斥反应的临床病理研究一例

目的 探讨小肠移植后亚临床型细胞性排斥反应(SCR)的临床表现、肠镜下改变和病理特点.方法 小肠移植1例,受者为女性,34岁,供者为男性.应用抗CD52单克隆抗体行诱导治疗,术后单用他克莫司(Tac)、无皮质激素的维持治疗方案.怀疑发生可疑排斥反应(IND)级至I级排斥反应时,提高血Tac浓度,行短程小剂量皮质激素治疗,排斥反应控制不佳时,则行甲泼尼龙冲击治疗;发生中度排斥反应时提高血Tac浓度,给予甲泼尼龙2 g,随后应用皮质激素递减方案.术后头2个月内,每周行2次肠镜和病理学检查,之后频次减为1次/周.结果 至随访结束患者已存活19个月(611 d),期间共发生有临床症状的急性排斥反应6次,亚临床排斥反应3次.3次亚临床排斥反应时,2次肠镜下未见明显改变,1次表现为斑点状的充血、水肿,放大肠镜下绒毛数量轻度减少.3次亚临床排斥反应的病理检查中,1次以黏膜上皮剥脱为主,隐窝上皮损伤较轻,组织学改变符合轻度急性排斥反应;而另2次以隐窝上皮的损伤为主,为可疑急性排斥反应.结论 SCR可能是临床排斥反应的早期阶段,无明显临床症状,肠镜下改变不明显,诊断主要依靠病理学检查,但必须排除移植肠血管病变、肠梗阻、各类炎症等术后并发症.     

Ultrastructural changes in the microvilli as a marker of small bowel rejection

Small bowel rejection occurs in patches; therefore, to detect bowel rejection in situations where a stomal biopsy appears normal under the light microscope, we studied the ultrastructural changes in bowel microvilli following heterotopic small bowel transplantation in rats. Thin sections of bowel biopsy specimens, which appeared normal under a light microscope, were selected and examined under an electron microscope for microvillous changes. Microvillous changes were seen in both the syngeneic and allogeneic groups on the 2nd and 4th postoperative days, but these changes were absent in the syngeneic group by the 8th postoperative day, although they were still detected in the allogeneic group. Thus, following small bowel transplantation, electron microscopic analysis is recommended to confirm rejection with a patchy distribution after the 8th postoperative day.     

Functional, histological, and inflammatory changes in chronically rejecting small bowel transplants

Our aim was to develop a model of chronic rejection (CR) in small bowel allografts, and to study the changes occurring in these grafts. Small bowel transplantation was performed using the DA to AS rat strain combination. Short-term (5 mg/kg intramuscular, from days − 2 to + 9), or long-term cyclosporin treatment (5 mg/kg, 3 times a week until day 50) was given to prevent acute rejection. Controls were untreated allografts, DA isografts with and without cyclosporin, and normal DA and AS rats. They were followed for 50 and 100 days after transplantation. Recipients of a syngeneic graft lost weight during the first week after transplantation, but started to regain weight and kept growing thereafter. Histology showed normal bowel architecture with normal mesenteric lymph nodes and Peyers patches. Vigorous acute rejection occurred in the untreated allografts. Animals had persistent weight loss, and were killed between 6–13 days after transplantation. No clinical signs of graft-versus-host disease were seen. Histology showed end-stage acute rejection. In both cyclosporin-treated allografted groups the postoperative course was as in the isografted animals. However, all animals had histologic signs of CR by 50 and 100 days after transplantation. Changes were most prominent in the mesentery. Serositis with increased vascularity, inflammation with sclerosis, and patchy myointimal proliferation with endothelialitis of the mesenteric vessels were found. Changes in the bowel were patchy and included some thickening of the muscle coat, crypt hyperplasia, scattered necrotic cells in the crypts, slight blunting of villi and loss of goblet cells. Infiltrating cells in the mesentery and bowel consisted mainly of CD 4⁺ cells, CD 8⁺ T-cells and monocytes/macrophages. Lactulose-mannitol urinary excretion ratio was significantly increased in short-term cyclosporin treated allografts at days 50 and 100 posttransplant. Serum albumin levels were significantly lowered in this group at both time points examined. We developed two models in which CR occurs after small bowel transplantation. Long-term cyclosporin treatment delayed the development of CR, since functional abnormalities were only seen in the animals that were treated with short-term cyclosporin. Received: 19 January 1999/Accepted: 19 July 1999     

Changes in blood lymphocyte populations in experimental bowel allograft rejection

Abstract  The aim of this study is to measure percentages of lymphocyte populations and IL-2R cellular expression in peripheral blood during the rejection of a small bowel allograft (SBA) in the rat. Thirty rats were allotted to three groups: A, control, no transplantation (Tx); B, rats receiving an orthotopic SBA; C, similar SBA but with thymostimulin (TP-1) administered before Tx, aimed at increasing the intensity of and accelerating rejection. The percentages of CD19, CD5, CD4 and CD8 cells and of IL-2R were determined when rejection was present. Rejection appeared in rats in group B between days 11 and 26 post-Tx and in group C between days 6 and 7 post-Tx ( P < 0.001). In both B and C groups, CD.5 and CD4 cells decreased ( P < 0.005) and CD8 cells increased ( P < 0.001). A correlation between CD8 and IL-2R content was found ( P < 0.05). In group C, earliness of rejection correlated with the percentage of CD8 cells ( P < 0.05) and the intensity of rejection with numbers of CD8 and CD19 cells ( P< 0.05).     

前列腺癌患者睾丸切除术前后外周血淋巴细胞表型和NK细胞的变化

为探讨前列腺癌患者抗肿瘤免疫活性，采用间接免疫荧光染色流式细胞计数分析技术检测了35例前列腺癌患者睾丸切除术前后外周血淋巴细胞表型（CD）和NK细胞的变化。结果前列腺癌患者CD细胞、CD4／CD8及NK细胞数均低于正常对照者，CD20细胞增多。睾丸切除术后，前列腺癌无转移的患者CD4细胞、CD4／CD8明显增高，NK细胞数接近正常水平；有转移的患者NK细胞升高较少，与术前比较无统计学差异。认为前列腺癌元转移的患者免疫功能损伤轻，术后恢复快，其预后好于已有转移的晚期患者。