肺部相关疾病外周血T淋巴细胞表面标志物表达分析

目的观察肺部相关疾病外周血T淋巴细胞表面标志物的表达,从细胞免疫水平探究肺部相关疾病发病机制。方法选择2016年1-12月于浙江省绍兴市立医院呼吸科就诊的肺部疾病患者84例,根据诊断结果分为肺结核组(n=34)、肺癌组(n=25)及非结核性肺炎组(n=25),同时设立健康对照组(n=35)。检测各组外周血T细胞表面表达CD3^+CD4^+、CD3^+CD8^+、CD3^+CD45RA+/CD45RO^+、CD3^+HLA-DR^+、CD8^+HLA-DR^+、CD4^+CD25^+的百分比,采用t检验对结果进行统计分析。结果肺结核组、肺癌组、非结核性肺炎组外周血T淋巴细胞表面标志物CD4^+/CD8^+比值(1.01±0.48、1.17±0.39、1.35±0.55)低于健康对照组(1.48±0.52,t=2.562,t=2.341,t=2.112,P<0.05);肺结核组、肺癌组、非结核性肺炎组表达CD3^+CD45RO^+的T细胞占总淋巴细胞百分比(65.20%±12.63%、56.70%±9.98%、55.90%±9.29%)高于健康对照组(49.60%±11.52%,t=3.422,t=2.647,t=2.084,P<0.05),且肺结核组高于肺癌和非结核性肺炎组(t=2.153,t=3.112,P<0.05);肺结核组、肺癌组表达CD3^+HLA-DR^+的T细胞占总淋巴细胞百分比(19.59%±7.01%、21.7%±7.34%)高于健康对照组(11.40%±5.33%,t=2.383,t=2.533,P<0.05);肺结核组表达CD8^+HLA-DR^+T细胞占总淋巴细胞百分比(11.26%±4.88%)高于健康对照组(7.10%±3.07%,t=2.244,P<0.05);肺结核组和肺癌组表达CD4^+CD25^+的T细胞占总淋巴细胞百分比(10.70%±3.06%、10.40%±2.33%)高于健康对照组(8.20%±2.79%,t=2.647,t=2.662,P<0.05)。结论肺结核、肺癌和肺炎患者外周血T淋巴细胞表面标志表达改变,尤以肺结核患者改变最显著,可能与肺结核独特的发病机制有关。

Expression of T lymphocyte surface markers in peripheral blood of patients with pulmonary disease

ObjectivesTo observe the expression of T lymphocyte surface markers in peripheral blood of patients with pulmonary disease, and explore the pathogenesis of pulmonary disease from the level of cellular immunity.MethodsEighty four patients with pulmonary diseases receiving treatment in pneumology department of Shaoxing Hospital from January to December, 2016 were divided into tuberculosis (TB) group (34 cases), the lung cancer (LC) group (25 cases) and non-tuberculosis pneumonia (NTP) group (25 cases) according to the diagnosis, and a healthy control (HC) group (35 cases) was set up simultaneously. The percentages of CD3＋CD4＋, CD3＋CD8＋, CD3＋CD45RA＋/ CD45RO＋, CD3＋HLA-DR＋, CD8＋HLA-DR＋ and CD4＋CD25＋ T cells in peripheral blood of all experimental groups were detected, and the results were statistically analyzed using t test.ResultsThe ratios of CD4＋/CD8＋ of TB group (1.01±0.48), LC group (1.17±0.39) and NTP group (1.35±0.55) were lower compared with HC group (1.48±0.52) (t＝2.562, t＝2.341, t＝2.112, P＜0.05). The percentages of CD3＋CD45RO＋ cells in total T lymphocyte of TB group (65.20%±12.63%), LC group (56.70%±9.98%) and NTP group (55.90%±9.29%) were higher than that of HC group (49.60% ±11.52%, t＝3.422, t＝2.647, t＝2.084, P＜0.05), and that of TB group was higher than those of LC and NTP groups (t＝2.153, t＝3.112, P＜0.05); The percentages of CD3＋HLA-DR＋ cells of TB group (19.59%±7.01%) and LC group (21.70%±7.34%) in total T lymphocyte were higher than that of HC group (11.40%±5.33%, t＝2.383, t＝2.533, P＜0.05); The percentage of CD8＋HLA-DR＋cells in total T lymphocyte was higher in TB group (11.26%±4.88%) than in HC group (7.10%±3.07%, t＝2.244, P＜0.05). The percentages of CD4＋CD25＋cells in total T lymphocyte increased in TB group (10.70%±3.06%) and LC group (10.40%±2.33%) compared with HC group (8.20%±2.79%, t＝2.647, t＝2.662, P＜0.05). ConclusionThe expressions of surface markers of T lymphocytes in peripheral blood changed in patients with tuberculosis, lung cancer and pneumonia, especially in TB patients. For TB patients, it might be associated with the unique pathogenesis of tuberculosis.