流式细胞术检测胸腔积液和外周血T淋巴细胞亚型及比例的研究

目的:探讨流式细胞技术检测恶性、结核性胸腔积液(PE)和外周血中T淋巴细胞亚型及比例的临床意义.方法:用流式细胞技术检测53例为结核性胸腔积液(PE)、62例为恶性积液患者和17例单纯性漏出液的胸水中的T淋巴细胞亚型及比例.结果:结核性胸腔积液患者胸水中淋巴细胞总数高于恶性胸腔积液或单纯漏出性胸腔积液患者(P=0.032),差异有统计学意义.亚型分析表明主要为T淋巴细胞,其中结核性和单纯漏出性胸腔积液的CD4+T细胞和CD4+/CD8+比值明显高于恶性胸腔积液(均为P＜0.05),而恶性胸腔积液患者的CD8+T细胞则明显高于结核性和单纯漏出性胸腔积液的患者(P=0.006).不同细胞亚型在结核性、恶性和单纯漏出性胸腔积液中无明显差别(P＞0.05).结论:结核性和单纯漏出性PE中CD4+T细胞和D4+/CD8+比值高于恶性肿瘤的患者,可作为鉴别诊断的参考.

Detection of T Lymphocyte Subtypes in Patients with Malignant and Tubercular Pleural Effusion by Flow Cytometry

Objective: To investigate the significance of the subtypes and ratio of T lymphocyte in patients with malignant and tubercular pleural effusion by flow cytometry.Methods: The subtypes and ratio of T lymphocyte from 53 tubercular pleural effusion,62 malignant pleural effusion,and 17 transudative pleural effusion were detected by flow cytometry(FCM).Results: The lymphocyte counts in the tubercular pleural effusion were higher than in the malignant pleural effusion and transudative pleural effusion(both P<0.05).T lymphocyte was the main subtype,CD4+ T and CD4+/CD8+ of tubercular pleural effusion and transudative pleural effusion were higher than that respectively of malignant pleural effusion(all P<0.05).While CD8+ T lymphocytes were more in the malignant pleural effusion(P=0.006).For the subtype classification,there is no significant difference among the different pleural effusion(P>0.05).Conclusion: The CD4+ T counts and CD4+/CD8+ratio were helpful to differentiate malignant effusion from transudative and tubercular pleural effusion.