结核性与恶性胸腔积液中CD4+CD25+调节性T细胞及相关因子的检测

目的检测结核性胸腔积液及恶性胸腔积液中D₄⁺ CD₂₅⁺调节性T细胞的分布与可溶性白介素-2受体(sIL-2R)及转化生长因子β1(TGF-β1)浓度,并探讨良恶性胸腔积液患者的局部免疫机制。方法47例结核性胸腔积液及34例肺癌并恶性胸腔积液患者于第1次抽液时留取胸腔积液,ELISA法检测sIL-2R及TGF-β1的浓度,Ficoll梯度离心分离单个核细胞,抗体标记后应用流式细胞仪分析D₄⁺ CD₂₅⁺调节性T细胞占淋巴细胞的比例。结果47例结核性胸腔积液与34例肺癌并恶性胸腔积液中D₄⁺ CD₂₅⁺调节性T细胞占淋巴细胞的比例分别为(8.7±0.6)%、(21.1±2.3)%,有显著性差异(P<0.05);结核性胸腔积液与恶性胸腔积液中sIL-2R浓度分别为(563.2±92.61)ng/ml,(390.12±101.12)ng/ml,有显著性差异(P<0.05);恶性胸腔积液中TGF-β1的水平(88.4±16.7mg/L),显著高于结核性胸腔积液组(40.3±3.6mg/L),结核性胸腔积液中sIL-2R、TGF-β1浓度与D₄⁺ CD₂₅⁺调节性T细胞占淋巴细胞的比例均无明显相关关系(P>0.05)。结论D₄⁺ CD₂₅⁺调节性T细胞,sIL-2R及TGF-β1可作为判定结核或恶性胸腔积液的辅助诊断指标。

The Detection of CD4 + CD25 + regulatory T cell and correlation factors in malignant and tuberculous pleural effusion

Objective To detect the proportion of CD₄⁺ CD₂₅⁺ regulatory T cell and the level of sIL-2R and TGF-βl in malignant and tuberculous pleural effusion to investigate the local immune mechanism. MethodsThe level of sIL-2R and TGF-βl in malignant and tuberculous pleural effusion were detected by ELISA.Mononuclear cells were separated on a ficoll density gradient.labelled with antibodies,and then analyzed by flow cytometry. Results The percentage of CD₄⁺ CD₂₅⁺ regulatory T cells in malignant pleural effusion was significantly higher than that in tuberculous pleural effusion(21.1±2.3% vs 8.7±0.6%,P<0.05).The levels of sIL-2R in malignant and tuberculous pleural effusion were 563.2±92.61ng/L,390.12±101.12ng/L(P<0.05),respectively.There were not correlation between the level of sIL-2R and TGF-βl and the proportion of D₄⁺ CD₂₅⁺ regulatory T cells in tuberculous pleural effusion.The level of TGF-βl in malignant pleural effusion was higher than that in tubereulous pleural effusion(88.4±16.7mg/L vs 40.3±3.6mg/L,P<0.05). Conclusion D₄⁺ CD₂₅⁺ regulatory T cell,sIL-2R and TGF-βl could be used to distinguish malignant and tuberculous pleural effusion.