外周血CD3^+CD161^+淋巴细胞检测在结核病诊断中的价值初探  

Detection of CD3^+CD161^+cell expression in tuberculosis patients and its application in diagnosis of tuberculosis

作　　者：张洁云[1] 张明霞[1] 陈骑[1] 邓国防[1] 邓群益[1] 陈涛[1] 杨倩婷[1] ZHANG Jie-yun;ZHANG Ming-xia;CHEN-Qi;DENG Guo-fang;DENG Qun-yi;CHEN Tao;YANG Qian-ting(Guangdong Key Laboratory of Emerging Infectious Disease,the Third People’s Hospital of Shenzhen,Shenzhen,Guangdong 518112,China)

机构地区：[1]深圳市第三人民医院/广东省新发传染病诊治重点实验室,广东深圳518112

出　　处：《临床肺科杂志》2020年第11期1626-1630,共5页Journal of Clinical Pulmonary Medicine

基　　金：“十三五”国家科技重大专项(No.2017ZX10201301-001-002);国家自然科学基金(No.81671984);深圳市基础研究计划基础研究项目(No.JCYJ20160427184123851、No.JCYJ20160427151540695);深圳医疗卫生“三名工程”(No.SZSM201412001)。

摘　　要：目的检测外周血CD3^+CD161^+淋巴细胞在结核病人中的表达水平,探讨其应用价值。方法选择菌阳结核病人40例、菌阴结核病人37例、潜伏感染者20例、健康对照者30例。采用流式细胞仪检测各组人群外周血CD3^+CD161^+淋巴细胞水平。通过绘制ROC曲线,评价其对结核病的诊断效能。结果菌阳组和菌阴组CD3^+CD161^+淋巴细胞表达水平分别为(17.59±1.36)%和(16.89±0.83)%,均明显低于对照组[(30.05±1.27)%]和潜伏感染组[(26.88±1.30)%],差异有统计学意义(F=30.77,P<0.01)。根据绘制的ROC曲线,CD3^+CD161^+淋巴细胞在分辨对照组和菌阳组时曲线下面积(AUC)为0.945,敏感度为82.5%,特异度为93.33%;在分辨潜伏感染组和菌阳组时AUC为0.913,敏感度为82.5%,特异度为95%;在分辨对照组和菌阴组时AUC为0.892,敏感度为81.08%,特异度为96.67%;在分辨潜伏感染组和菌阴组时AUC为0.868,敏感度为81.08%,特异度为95.0%。结论结核病人CD3^+CD161^+淋巴细胞下降明显,能够较好地分辨菌阳和菌阴结核病患者与健康人和潜伏感染者,可考虑作为诊断结核病的候选分子标志。Objective To study the expression level of CD3^+CD161^+cell in different cohorts.Methods 127 tuberculosis patients or healthy persons were enrolled,including 40 bacterial positive patients,37 bacterial negative patients,20 latent infection patients,and 30 controls.The levels of CD3^+CD161^+cells in peripheral blood were measured by flow cytometry,and the differences among different groups were compared.The diagnostic efficacy of CD3^+CD161^+cells for tuberculosis was evaluated by drawing ROC curve.Results The expression levels of CD3^+CD161^+cells in peripheral blood of bacterium-positive tuberculosis patients and bacterium-negative tuberculosis patients were(17.59±1.36)%and(16.89±0.83)%respectively,which were significantly lower than those of healthy controls((30.05±1.27)%)and latent tuberculosis infection patients((26.88±1.30)%)(F=30.77,P<0.001).The area under the curve(AUC)of CD3^+CD161^+cell was 0.945 for diagnosing bacterial positive patients and latent infections,with the sensitivity of 82.5%and the specificity of 93.33%.The AUC of CD3^+CD161^+cell was 0.945 for diagnosing healthy controls and bacterial negative patients,with the sensitivity of 82.5%and the specificity of 95%.The AUC of CD3^+CD161^+cell was 0.892 for diagnosing bacterial positive patients and latent infections,with the sensitivity of 81.08%and the specificity of 96.67%.The AUC of CD3^+CD161^+cell was 0.868 for diagnosing bacterial positive patients and latent infections,with the sensitivity of 81.08%and the specificity of 95%.Conclusion CD3^+CD161^+cells in tuberculosis patients decrease significantly,which can better distinguish positive and negative tuberculosis patients from healthy controls and latent infections,and can be considered as a candidate molecular marker for the diagnosis of tuberculosis.

关 键 词：T淋巴细胞亚群 NK细胞凝集素样受体亚家族B 结核 流式细胞术 分子诊断技术 评价研究 

分 类 号：R52[医药卫生—内科学] R446.6[医药卫生—临床医学]