Cascio G, Anania A, Mazzetti R, Scappaticci E, Canavera R M, Marinuzzi G
Department of Medicine B, University of Turin, Italy.
Panminerva Med. 1993 Sep;35(3):127-30.
Direct observation with an optic fibre bronchoscope facilitates the diagnosis, staging and treatment of both neoplastic and other lung diseases, and the varying diameters available enable IVth or even Vth-order bronchi to be examined. The technique can be employed for deep lung lavage or bronchoalveolar lavage (BAL) and for transbronchial biopsy. The BAL fluid, too, can be used to study lung cells and soluble components. In this study, 21 patients aged 32-79 (mean 55.5), namely 16 with lung cancer and with non-neoplastic lung diseases, were subjected to BAL to allow a study to be made of the BAL fluid cell composition. In the neoplastic group, CD3 lymphocytes were 41.3% compared with 63.2% in the peripheral blood. CD4 (24.6% vs 40.6%) and CD8 (16.6% vs 28.7%) displayed the same pattern. The CD4/CD8 ratio, on the other hand, was much the same in both groups: 1.7 vs 1.5. CD19 were higher in the BAL fluid (20.1%) than in the peripheral blood (4.8%). In the non-neoplastic group the differences between the BAL fluid and the peripheral blood are of the same sign, but less marked. In conclusion, the BAL fluid subset composition in primary lung neoplasia differs from that in the peripheral blood through a reduction of CD3, CD4 and CD8 and an increase in CD19 compared with the peripheral blood. These modifications are less evident in patients with non-neoplastic lung diseases.
使用光纤支气管镜进行直接观察有助于诊断、分期以及治疗肿瘤性和其他肺部疾病，其不同的直径能够检查到四级甚至五级支气管。该技术可用于深部肺灌洗或支气管肺泡灌洗（BAL）以及经支气管活检。BAL液也可用于研究肺细胞和可溶性成分。在本研究中，对21名年龄在32 - 79岁（平均55.5岁）的患者进行了BAL，其中16例患有肺癌，5例患有非肿瘤性肺部疾病，以便对BAL液细胞组成进行研究。在肿瘤组中，CD3淋巴细胞占41.3%，而外周血中为63.2%。CD4（24.6%对40.6%）和CD8（16.6%对28.7%）呈现相同模式。另一方面，两组的CD4/CD8比值大致相同：分别为1.7和1.5。BAL液中的CD19高于外周血（20.1%对4.8%）。在非肿瘤组中，BAL液与外周血之间的差异具有相同的趋势，但不太明显。总之，与外周血相比，原发性肺肿瘤中BAL液亚群组成的差异在于CD3、CD4和CD8减少，CD19增加。这些改变在非肿瘤性肺部疾病患者中不太明显。
