摘要
目的探讨单核细胞人白细胞抗原-DR (HLA-DR)和CD16检测在炎症性疾病中的应用价值。方法选取炎症性疾病患者56例,以体检健康者40名作为正常对照组。采用流式细胞术检测所有对象外周血单核细胞HLA-DR和CD16表达量[HLA-DR平均荧光强度(MFI)、CD16 MFI]、阳性细胞百分比(HLA-DR+%、CD16+%)及阳性分子的MFI(HLA-DR+MFI、CD16+MFI),并分析单核细胞HLA-DR、CD16表达与白细胞各项指标[中性粒细胞绝对数(NEUT#)、中性粒细胞百分数(NEUT%)、淋巴细胞绝对数(LYMPH#)、淋巴细胞百分数(LYMPH%)、单核细胞绝对数(MO#)、单核细胞百分数(MO%)及中性粒细胞/淋巴细胞比值(NLR)]之间的相关性。采用受试者工作特征(ROC)曲线评估单核细胞HLA-DR、CD16诊断炎症性疾病的价值。结果炎症性疾病组NEUT#、NEUT%、MO#及NLR均明显高于正常对照组(P<0.01),而LYMPH#和LYMPH%均明显低于正常对照组(P<0.01)。炎症性疾病组单核细胞HLA-DR MFI、HLA-DR+%及HLA-DR+MFI均明显低于正常对照组(P<0.01),而单核细胞CD16 MFI、CD16+%及CD16+MFI均明显高于正常对照组(P<0.01)。单核细胞HLA-DR+%、HLA-DR MFI、HLA-DR+MFI、CD16 MFI和CD16+MFI与NEUT#、NEUT%、LYMPH#、LYMPH%、NLR、MO#均相关(P<0.01),与MO%无相关性(P>0.05);单核细胞CD16+%与NEUT#、LYMPH#、LYMPH%、NLR、MO#、MO%相关(P<0.05),与NEUT%无相关性(P>0.05)。ROC曲线分析显示,单核细胞HLA-DR+%、HLA-DR MFI、HLA-DR+MFI、CD16+%、CD16 MFI和CD16+MFI诊断炎症性疾病的曲线下面积(AUC)分别为0.944、0.944、0.924、0.722、0.911、0.979。结论单核细胞HLA-DR和CD16可用于炎症性疾病的诊断,还可作为辅助评估炎症反应程度及监测机体免疫状态的指标。
Objective To evaluate the role of monocytic human leukocyte antigen-DR(HLA-DR)and CD16 determinations in inflammatory diseases.Methods A total of 56 patients with inflammatory diseases and 40 healthy subjects(healthy control group)were enrolled for the determinations of HLA-DR and CD16 expression levels[HLA-DR mean fluorescence intensity(MFI)and CD16 MFI],the percentages of positive HLA-DR and CD16(HLA-DR+%and CD16+%)and MFI(HLA-DR+MFI and CD16+MFI)by flow cytometry.The correlations of HLA-DR and CD16 expression levels with neutrophil absolute value(NEUT#),neutrophil percentage(NEUT%),lymphocyte absolute value(LYMPH#),lymphocyte percentage(LYMPH%),monocyte absolute value(MO#),monocyte percentage(MO%)and neutrophil/lymphocyte ratio(NLR)were evaluated.The diagnostic roles of HLA-DR and CD16 in inflammatory diseases were evaluated by receiver operating characteristic(ROC)curve.Results Compared with healthy control group,NEUT#,NEUT%,MO#and NLR in inflammatory disease group were higher(P<0.01),and LYMPH#and LYMPH%were lower(P<0.01).HLA-DR+%,HLA-DR MFI and HLA-DR+MFI in inflammatory group were lower than those in healthy control group(P<0.01),while CD16 MFI,CD16+%and CD16+MFI were higher(P<0.01).HLA-DR+%,HLA-DR MFI,HLA-DR+MFI,CD16 MFI and CD16+MFI were correlated with NEUT#,NEUT%,LYMPH#,LYMPH%,NLR and MO#(P<0.01),and there was no correlation with MO%(P>0.05).CD16+%was correlated with NEUT#,LYMPH#,LYMPH%,NLR,MO#and MO%(P<0.05),and there was no correlation with NEUT%(P>0.05).ROC curve analysis showed that the areas under ROC curves(AUC)of HLA-DR+%,HLA-DR MFI,HLA-DR+MFI,CD16+%,CD16 MFI and CD16+MFI for the diagnosis of inflammatory disease were 0.944,0.944,0.924,0.722,0.911 and 0.979,respectively.Conclusions The determinations of monocytic HLA-DR and CD16 can be used for the diagnosis of inflammatory diseases,and monocytic HLA-DR and CD16 can be used to assess the severity of inflammation and monitor immune status.
作者
章黎华
王维维
张良
沈立松
ZHANG Lihua;WANG Weiwei;ZHANG Liang;SHEN Lisong(Department of Clinical Laboratory,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China;Department of Urology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)
出处
《检验医学》
CAS
2018年第9期775-780,共6页
Laboratory Medicine
基金
国家自然科学基金资助项目(81672363)
上海市青年临床医技人才(临床检验专业)培养计划(沪医卫基[2016]05号)
