Mehraban Zahra, Pourdowlat Guitti, Mortaz Esmaeil, Atefeh Abedini, Ghaforian Amin R, MalAmir Mehrdad Dargahi, Bakhtiari Nima
Assistant Professor of Pulmonology, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
Tracheal Diseases Research Centre, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), ShahidBeheshti University of Medical Sciences, Tehran, Iran.
J Family Med Prim Care. 2022 Nov;11(11):6843-6847. doi: 10.4103/jfmpc.jfmpc_2296_21. Epub 2022 Dec 16.
There are two main causes of exudative effusion including malignancy-induced effusion and tuberculosis. Considering that in reactive ejections, such as tuberculosis-induced effusion, the role of B lymphocytes and in the malignant effusion, the role of T lymphocytes are more important, in this study we analyzed the frequency of CD4, CD8, CD19, CD56-16, CD64, QuantiFERON in the pleural and serum samples of patients with exudative lymphocytic-dominant effusion.
In total, 73 patients were enrolled in the study by exudative lymphocyte effusion, and finally, 63 patients had definite diagnoses. The patients were sorted into three groups including malignant, tuberculosis, and none. The sample of blood plasma and pleural effusion were collected and CD markers were analyzed using flow cytometry.
The mean age in the malignancy and tuberculous (TB) groups was 63.16 ± 12 and 52.15 ± 22.62, respectively. There was no significant difference in the frequency of CD8, CD4, and CD16-56 cells in blood samples of patients with tuberculosis and malignancy. Compared to those with tuberculosis, the percentage of CD64 cells was significantly higher in patients with tuberculosis than in malignant subjects. Moreover, a comparison of the frequency of cells with CD8, CD4, CD19, CD64, CD16-56, and CD14 markers in pleural samples showed no significant difference between groups. Other inflammatory factors were also investigated. The erythrocyte sedimentation rate (ESR) value for tuberculosis patients was significantly higher than malignancy. Also, QuantiFERON was positive in 14.3% of malignant patients, and 62.5% of patients with TB, which had a significant difference.
Considering that there are many confounding variables in the study, such as previous medications, subtypes of , and race of patients conducting studies in different groups and performing data mining for using a set of parameters can be used to detect the exact diagnosis.
渗出性积液的主要原因有两种,包括恶性肿瘤引起的积液和结核病。考虑到在反应性渗出中,如结核性积液,B淋巴细胞起主要作用,而在恶性积液中,T淋巴细胞起主要作用,在本研究中,我们分析了渗出性淋巴细胞为主的积液患者胸膜和血清样本中CD4、CD8、CD19、CD56 - 16、CD64、结核感染T细胞检测的频率。
本研究共纳入73例渗出性淋巴细胞积液患者,最终63例患者得到明确诊断。患者分为三组,包括恶性肿瘤组、结核组和非上述疾病组。采集血浆和胸腔积液样本,采用流式细胞术分析CD标志物。
恶性肿瘤组和结核组患者的平均年龄分别为63.16±12岁和52.15±22.62岁。结核病患者和恶性肿瘤患者血液样本中CD8、CD4和CD16 - 56细胞的频率无显著差异。与恶性肿瘤患者相比,结核病患者CD64细胞的百分比显著高于恶性肿瘤患者。此外,胸膜样本中具有CD8、CD4、CD19、CD64、CD16 - 56和CD14标志物的细胞频率在各组之间无显著差异。还研究了其他炎症因子。结核病患者的红细胞沉降率(ESR)值显著高于恶性肿瘤患者。此外,14.3%的恶性肿瘤患者结核感染T细胞检测呈阳性,62.5%的结核病患者呈阳性,差异有统计学意义。
考虑到本研究中有许多混杂变量,如既往用药情况、患者的亚型以及种族等,在不同组中开展研究并使用一组参数进行数据挖掘可用于准确诊断。