Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
J Clin Immunol. 2012 Jun;32(3):430-7. doi: 10.1007/s10875-011-9644-1. Epub 2012 Jan 8.
This retrospective study aimed to characterize the clinical hematological and immunological features of patients with thymic epithelial neoplasms.
From a cohort of 512 patients with thymic epithelial neoplasms, 79 patients diagnosed with autoimmune/immunodeficiency conditions or signs and/or symptoms suggesting an autoimmune or immunodeficiency state were evaluated by standard immunological and hematological testing.
Elevated percentages of CD2+, CD3+, and CD8+ lymphocytes were observed in 44 (57.1%), 33 (41.8%), and 32 (40.5%) patients. Low CD4+ and CD19+ percentages were observed in 25 (31.6%) and 36 (46.2%), respectively; CD4+:CD8+ ratios were inverted in 18 (22.8%). IgG, IgA, and IgM levels were low in 12 (15.8%), 9 (11.7%) and 15 (19.7%) patients, respectively. Patients with immunodeficiency condition(s) were more likely to have high CD8+ percentages (p = 0.040), low CD19+ percentages (p = 0.025), and/or inverted CD4+/CD8+ ratios (p = 0.034). Patients with autoimmune condition(s) were more likely to have a high/normal CD4+ percentage (p = 0.038). High CD2+ percentages were associated with lower mean IgG and IgA levels (p = 0.030 and p = 0.017, respectively). High CD3+ and CD8+ percentages were associated with lower mean IgA levels (p = 0.046 and p = 0.013, respectively). Low CD19+ percentages were associated with lower mean IgG and IgA levels (p = 0.004 and p < 0.001, respectively).
Signs/symptoms and history of autoimmune and immunodeficiency conditions among patients with thymic epithelial neoplasms are associated with high frequencies of abnormalities in immunoglobulin levels and lymphocyte immunophenotypes, suggesting a role for their assessment.
本回顾性研究旨在描述胸腺癌患者的临床血液学和免疫学特征。
在 512 例胸腺癌患者中，对 79 例诊断为自身免疫/免疫缺陷疾病或有自身免疫或免疫缺陷状态的体征和/或症状的患者进行了标准免疫学和血液学检测。
44 例（57.1%）、33 例（41.8%）和 32 例（40.5%）患者的 CD2+、CD3+和 CD8+淋巴细胞百分比升高。分别有 25 例（31.6%）和 36 例（46.2%）患者的 CD4+和 CD19+百分比降低；18 例（22.8%）患者的 CD4+/CD8+比值倒置。分别有 12 例（15.8%）、9 例（11.7%）和 15 例（19.7%）患者的 IgG、IgA 和 IgM 水平降低。存在免疫缺陷疾病的患者更有可能出现 CD8+百分比升高（p=0.040）、CD19+百分比降低（p=0.025）和/或 CD4+/CD8+比值倒置（p=0.034）。存在自身免疫疾病的患者更有可能出现 CD4+百分比升高/正常（p=0.038）。CD2+百分比升高与平均 IgG 和 IgA 水平降低相关（p=0.030 和 p=0.017）。CD3+和 CD8+百分比升高与平均 IgA 水平降低相关（p=0.046 和 p=0.013）。CD19+百分比降低与平均 IgG 和 IgA 水平降低相关（p=0.004 和 p<0.001）。
胸腺癌患者的自身免疫和免疫缺陷疾病的体征/症状和病史与免疫球蛋白水平和淋巴细胞免疫表型异常的高频率相关，提示评估这些疾病的作用。
