Wong Hsien Teik, Shahrizal Tengku A, Prepageran Narayanan, Lim Wye Keat, Raman Rajagopalan
Department of Otolaryngology, University Malaya Medical Center, Kuala Lumpur.
Ear Nose Throat J. 2007 May;86(5):292-4.
We conducted a prospective study of 60 patients in a tertiary care referral center to ascertain the status of cell-mediated immunity as determined by delayed hypersensitivity reactions in patients with nasopharyngeal carcinoma (NPC) or allergic rhinitis. Delayed hypersensitivity as detected by Mantoux testing is generally accepted as a reflection of the level of cell-mediated immunoactivity-the less hypersensitivity reaction that occurs, the lower the level of immunoactivity is, and vice versa. Our study population was made up of three groups: 20 newly diagnosed patients with NPC (pretreatment), 20 age- and sex-matched patients with allergic rhinitis, and 20 matched controls without either disease. A negative Mantoux test (0- to 5-mm induration) was seen in 13 patients with NPC (65.0%), in 17 patients with allergic rhinitis (85.0%), and in 16 controls (80.0%); none of these differences was statistically significant. However, it is interesting that while the NPC group had the lowest percentage of negative Mantoux results overall, it had the highest percentage of patients who had no reaction at all (i.e., 0-mm induration); a complete absence of any reaction was seen in 7 of the 13 Mantoux-negative NPC patients (53.8%), compared with 2 of the 17 Mantoux-negative allergic rhinitis patients (11.8%) and 3 of the 16 Mantoux-negative controls (18.8%). An absence of a reaction generally indicates a very limited degree of cell-mediated immunoactivity. Therefore, we conclude that patients with NPC appear to have significantly less cell-mediated immunity than do patients with allergic rhinitis and normal controls; no statistically significant difference was noted between the latter two groups.
我们在一家三级医疗转诊中心对60名患者进行了一项前瞻性研究，以确定鼻咽癌（NPC）患者或过敏性鼻炎患者中由迟发型超敏反应所决定的细胞介导免疫状态。通过结核菌素试验检测到的迟发型超敏反应通常被认为是细胞介导免疫活性水平的反映——发生的超敏反应越少，免疫活性水平越低，反之亦然。我们的研究对象由三组组成：20名新诊断的NPC患者（治疗前）、20名年龄和性别匹配的过敏性鼻炎患者以及20名无任何一种疾病的匹配对照。13名NPC患者（65.0%）、17名过敏性鼻炎患者（85.0%）和16名对照（80.0%）的结核菌素试验结果为阴性（硬结0至5毫米）；这些差异均无统计学意义。然而，有趣的是，虽然NPC组总体上结核菌素试验阴性的百分比最低，但完全无反应（即硬结0毫米）的患者百分比最高；在13名结核菌素试验阴性的NPC患者中有7名（53.8%）完全无任何反应，相比之下，17名结核菌素试验阴性的过敏性鼻炎患者中有2名（11.8%），16名结核菌素试验阴性的对照中有3名（18.8%）。无反应通常表明细胞介导免疫活性程度非常有限。因此，我们得出结论，NPC患者的细胞介导免疫似乎明显低于过敏性鼻炎患者和正常对照；后两组之间未观察到统计学上的显著差异。
