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目的:探讨细胞毒T淋巴细胞相关抗原4(CTLA-4)在结核性及恶性胸腔积液的分布及临床意义。方法:收集胸腔积液60份,其中癌性30份、结核性30份,酶联免疫法分别检测可溶性CTLA-4(sCTLA-4)的浓度,另随机取10例癌性和结核性胸液并分离出淋巴细胞,流式细胞仪检测CD3+CD8+T淋巴细胞表面CTLA-4的表达。结果:恶性胸腔积液中sCTLA-4的浓度均明显高于结核性,恶性胸液中CD3+CD8+T淋巴细胞表面CTLA-4的表达明显低于结核性,相比均有统计学意义。结论:CTLA-4可能在恶性胸腔积液微环境免疫状态形成中起重要作用,CTLA-4的检测在胸液鉴别诊断中可能有较大的临床意义。
Objective: To investigate the distribution and clinical significance of cytotoxic T lymphocyte associated antigen 4 (CTLA-4) in tuberculous and malignant pleural effusion. Methods: 60 cases of pleural effusion were collected, including 30 cancerous and 30 tuberculous. The concentration of soluble CTLA-4 (sCTLA-4) was detected by enzyme-linked immunosorbent assay. Ten cases of cancerous and tuberculous pleural effusion Lymphocytes were isolated and the expression of CTLA-4 on CD3 + CD8 + T lymphocytes was detected by flow cytometry. Results: The concentration of sCTLA-4 in malignant pleural effusion was significantly higher than tuberculous. The expression of CTLA-4 on CD3 + CD8 + T lymphocytes in malignant pleural effusion was significantly lower than that in tuberculous pleomorphism. Conclusion: CTLA-4 may play an important role in the formation of immune status of malignant pleural effusion microenvironment. The detection of CTLA-4 may have great clinical significance in the differential diagnosis of pleural effusion.