摘要
目的:对3型桥本甲状腺炎(Hashimoto thyroiditis,HT)进行T细胞免疫分型,并分析其与滤泡损害程度的相关性,为临床诊治提供依据。方法:对136例细针穿刺(fine needle aspiration biopsy．FNAB)HT标本进行组织学观察并分型(L、P、O型),检测各型患者血清学指标(TPOAb、TGAb、TSH),以20例非毒性甲状腺肿作对照。对其中60例、23例FNAB HT标本分别进行免疫组织化学染色及流式细胞术检查,比较各型HT组织T淋巴细胞浸润程度及CD3+、CD4+、CD8+T细胞分布情况。分析HT组织滤泡萎缩程度与T淋巴细胞浸润程度及分型的相关性。结果:FNAB组织学观察发现L型(n=58)、P型(n=28)滤泡萎缩程度比O型(n=20)严重(P<0．05)。免疫组化结果显示:L、P、O型HT组织T细胞表达率分别为45％～60％、30％～50％、18％～35％。流式细胞术检测HT组织L型CD3+、CD4+、CD8+T细胞表达率分别为47％～67％、22％～38％、17％～27％;P型分别为34％～36％、16％～18％、11％～13％;O型分别为33％～45％、16％～24％、12％～18％。L型滤泡萎缩程度与淋巴细胞漫润呈正相关(r=0．067),而O型(r=-0．29)、P型(r=-0．29)均与淋巴浸润呈负相关。结论:对FNAB标本进行T淋巴细胞免疫分型能直观反映HT变化程度．有助于临床诊治。
Objective：To study the phenotypes of T cell in patients with Hashimoto thyrioditis （HT） and to analyze its relationship with the impairment of follicles, so as to provide evidence for clinical diagnosis and treatment. Methods.. Totally 136 HT specimens were obtained by fine needle aspiration biopsy （FNAB） and were divided morphologically（L, P, O type）. The serum parameters （TPOAb, TGAb, TSH） were tested, and 20 cases with nontoxic goiter were taken as control. Immunohistochemical assay was performed with 60 specimens and FCM （Flow cytometry ） was used to study 23 specimens. The T cell infiltration and the distribution of CD3^＋ , CD4^＋ , and CD8^＋ T cells were compared between all types of HT tissues. The correlationship between the atrophic degree of follicle with T lymphocytes infiltration and phenotype was analyzed. Results.. It was found that L type （n=58） and P type （n=28） had more serious follicle atrophy than that of O type （n=20） （P〈0.05）. Immuno-histochemical assay showed that the average expression rate of T cells were 45%-60% for L type, 30%-50% for P type,and 18%-35% for O type. FCM results showed that the T ceil marker ratio were： for L type, CD3^＋ 47%-67%,CD4^＋ 22%-38%,CD8^＋ 17%-27%; for P type, CD3^＋ 34%-36%, CD4^＋ 16%-18%,CD8^＋ 11%-13%; for O type , CD3^＋ 33%-45%, CD4^＋ 16%-24% ,CD8^＋ 12%-18%. In L type, the follicle atrophic degree was positively correlated to lymphocyte infiltration level （r=0. 067）; however, O type （r= -0.29） and P type （r= -0.29） were both negative correlated to it. Conclusion： Phenotyping of T cells in FNAB specimens can directly reflect the changing degree of HT, which is helpful for clinical diagnosis and treatment.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2007年第4期372-376,共5页
Academic Journal of Second Military Medical University
关键词
甲状腺
甲状腺炎
自身免疫性
T淋巴细胞
免疫
细针穿刺活检
thyroid gland
thyroiditis, autoimmune
T-lymphocytes
immunity
fine needle aspiration biopsy
作者简介
叶廷军，副主任医师．Corresponding author．E-mail：yezhuanghui_1984@hotmail．com
