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目的:探讨穿孔素(PFN)在结核性和恶性胸腔积液中的分布以及其与胸腔积液微环境免疫状态的关系。方法:收集2007年9月-2008年6月武汉大学人民医院呼吸内科住院病人的胸腔积液60份,其中癌性30份、结核性30份,酶联免疫法分别检测PFN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淋巴细胞胞内PFN的表达。结果:恶性胸腔积液中PFN的浓度均明显低于结核性,恶性胸液中CD3+CD8+T淋巴细胞表面PFN的表达明显低于结核性,相比均有明显统计学意义。结论:PFN可能在恶性胸腔积液微环境免疫状态形成中起重要作用,PFN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 of perforin (PFN) in tuberculous and malignant pleural effusion and its relationship with the immune status of pleural effusion microenvironment. Methods: 60 cases of pleural effusion of inpatients of Department of Respiratory Medicine, Wuhan University People’s Hospital from September 2007 to June 2008 were collected. Among them, 30 were cancerous and 30 were tuberculous. The concentrations of PFN were detected by enzyme-linked immunosorbent assay Ten cases of cancerous and tuberculous pleural effusion were taken and lymphocytes were isolated. The expression of PFN in CD3 + CD8 + T lymphocytes was detected by flow cytometry. Results: The concentration of PFN in malignant pleural effusion was significantly lower than that in tuberculosis. The expression of PFN on CD3 + CD8 + T lymphocytes in malignant pleural effusion was significantly lower than that in tuberculous pleurisy, and the difference was statistically significant. Conclusion: PFN may play an important role in the formation of immune status of malignant pleural effusion microenvironment. The detection of PFN may have great clinical significance in the differential diagnosis of pleural effusion.