Mi Song, Cui Na, Wang Jing, Zhang Liming, Huang Kewu
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Infect Drug Resist. 2025 Sep 18;18:4971-4980. doi: 10.2147/IDR.S542415. eCollection 2025.
Lymphocyte profile (LP) analysis in mediastinal lymph nodes for differentiating reactive lymphadenopathy (RL) from tuberculous lymphadenitis (TBLA) remains understudied.
Patients with intrathoracic lymphadenopathy undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were enrolled. Lymph node puncture fluid (LNPF) was analyzed via flow cytometry to compare LP characteristics between TBLA and RL. Receiver operating characteristic (ROC) analysis identified optimal diagnostic cut-offs, and sensitivity, specificity, and accuracy were calculated.
A total of 41 TBLA cases and 45 RL cases were included. Compared with the TBLA group, the RL group exhibited increased proportions of CD4⁺ T cells and B cells, and decreased proportions of CD8⁺ T cells, natural killer (NK) cells, and natural killer T (NKT) cells in LNPF. Among single parameters, the CD4/CD8 ratio demonstrated the highest diagnostic performance for TBLA, with sensitivity of 88.89%, specificity of 70.73%, and accuracy of 80.23%. Among three-parameter combinations, the CD4⁺ T cell, CD8⁺ T cell, and NK cell ratio combination achieved optimal diagnostic performance, with sensitivity of 80.5%, specificity of 86.7%, and accuracy of 82.6%.
纵隔淋巴结中的淋巴细胞谱（LP）分析用于区分反应性淋巴结病（RL）和结核性淋巴结炎（TBLA）的研究仍较少。
纳入接受支气管内超声引导下经支气管针吸活检（EBUS-TBNA）的胸内淋巴结病患者。通过流式细胞术分析淋巴结穿刺液（LNPF），以比较TBLA和RL之间的LP特征。采用受试者操作特征（ROC）分析确定最佳诊断临界值，并计算敏感性、特异性和准确性。
共纳入41例TBLA病例和45例RL病例。与TBLA组相比，RL组LNPF中CD4⁺T细胞和B细胞比例增加，CD8⁺T细胞、自然杀伤（NK）细胞和自然杀伤T（NKT）细胞比例降低。在单个参数中，CD4/CD8比值对TBLA的诊断性能最高，敏感性为88.89%，特异性为70.73%，准确性为80.23%。在三参数组合中，CD4⁺T细胞、CD8⁺T细胞和NK细胞比值组合的诊断性能最佳，敏感性为80.5%，特异性为86.7%，准确性为82.6%。
