Plevral effüzyonlarda lenfosit altgruplarının monoklonal antikorlarla değerlendirilmesi
Evoluation of lymphocyte subtypes in pleural effusions with monoclonal antibodies
- Tez No: 40192
- Danışmanlar: PROF.DR. EMİN KANSU
- Tez Türü: Yüksek Lisans
- Konular: Allerji ve İmmünoloji, Onkoloji, Tıbbi Biyoloji, Allergy and Immunology, Oncology, Medical Biology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 1995
- Dil: Türkçe
- Üniversite: Hacettepe Üniversitesi
- Enstitü: Sağlık Bilimleri Enstitüsü
- Ana Bilim Dalı: Belirtilmemiş.
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 62
Özet
ABSTRACT Many different etiologies are responsible for the formation of pleural effusions. Differential diagnosis between benign and malign pleural effusions is difficult sometimes and it can't be done by using routine biochemical and cytological analysis. Monoclonal antibodies were developed in recent years and used successfully in clinical trials such as diagnosis and treatment of tumors. Today, monoclonal antibodies are one of the most reliable markers of cell surface antigens. Between January, 1994 and August, 1994 total 28 patient's pleural effusion were studied. All samples were evaluated by routine biochemical and cytological examinations. Additionally, using monoclonal antibodies, lymphocyte subtypes were studied. 11 patients had benign etiologies ( 7 tuberculous, 2 systemic lupus erythematosus, 1 pancreatitis and 1 congestive heart failure), 15 had malign etiologies ( 9 lung cancer, 5 breast cancer, 1 hepatocellular carcinoma). 2 patient with Burkitt's lymphoma were also studied but these two patients were not included in statistical analysis. Mean age was 43.0±9.3 years in benign group and it was 50.6 ±6.7 years in malign group( p= 0.045). Statististical analysis were performed by using Mann Whitney-U test. Because of mean ages were different between two groups, Spearman's correlation analysis were performed to all parameters. No correlation was observed. There was no difference between routine biochemical and cytological analysis between groups. Lymphocyte subtypes analysis were as follows: in benign group CD3% 63.2 ±8.8, absolute CD3 4372 ±2397/mm3, CD4% 46.0 ± 5411.2, absolute CD4 3113±1703/mm3, CD8% 21.3±6.1, absolute CD8 1531±1135/mm3, B% lymphocyte 6.4±2.6 and absolute B lymphocyte 431±245/mm3, in malign group CD3% 61.8±11.2, absolute CD3 3556±2007/mm3, CD4% 49.5±12.3, absolute CD4 2580±1778/mm3, CD8% 18.8±7.2, absolute CD8 1076±598/mm3, B% lymphocyte 8.4±3.9, absolute B lymphocyte 446±274/mm3. These values were not statistically different. In sharp contrast to low B lymphocyte counts in these groups, 2 Burkitt's lymphoma patients had 69% and 78% B lymphocytes in their pleural fluid sample. As a result we conclude that T lymphocytes, especially CD4+ T lymphocytes are the main effector cell type in both benign and malign pleural effusions. Low levels of B lymphocytes is another characteristic finding. Presence of high levels of B lymphocytes in pleural fluids may be seen in B cell neoplasm such as Burkitt's lymphoma. 55
Özet (Çeviri)
ABSTRACT Many different etiologies are responsible for the formation of pleural effusions. Differential diagnosis between benign and malign pleural effusions is difficult sometimes and it can't be done by using routine biochemical and cytological analysis. Monoclonal antibodies were developed in recent years and used successfully in clinical trials such as diagnosis and treatment of tumors. Today, monoclonal antibodies are one of the most reliable markers of cell surface antigens. Between January, 1994 and August, 1994 total 28 patient's pleural effusion were studied. All samples were evaluated by routine biochemical and cytological examinations. Additionally, using monoclonal antibodies, lymphocyte subtypes were studied. 11 patients had benign etiologies ( 7 tuberculous, 2 systemic lupus erythematosus, 1 pancreatitis and 1 congestive heart failure), 15 had malign etiologies ( 9 lung cancer, 5 breast cancer, 1 hepatocellular carcinoma). 2 patient with Burkitt's lymphoma were also studied but these two patients were not included in statistical analysis. Mean age was 43.0±9.3 years in benign group and it was 50.6 ±6.7 years in malign group( p= 0.045). Statististical analysis were performed by using Mann Whitney-U test. Because of mean ages were different between two groups, Spearman's correlation analysis were performed to all parameters. No correlation was observed. There was no difference between routine biochemical and cytological analysis between groups. Lymphocyte subtypes analysis were as follows: in benign group CD3% 63.2 ±8.8, absolute CD3 4372 ±2397/mm3, CD4% 46.0 ± 5411.2, absolute CD4 3113±1703/mm3, CD8% 21.3±6.1, absolute CD8 1531±1135/mm3, B% lymphocyte 6.4±2.6 and absolute B lymphocyte 431±245/mm3, in malign group CD3% 61.8±11.2, absolute CD3 3556±2007/mm3, CD4% 49.5±12.3, absolute CD4 2580±1778/mm3, CD8% 18.8±7.2, absolute CD8 1076±598/mm3, B% lymphocyte 8.4±3.9, absolute B lymphocyte 446±274/mm3. These values were not statistically different. In sharp contrast to low B lymphocyte counts in these groups, 2 Burkitt's lymphoma patients had 69% and 78% B lymphocytes in their pleural fluid sample. As a result we conclude that T lymphocytes, especially CD4+ T lymphocytes are the main effector cell type in both benign and malign pleural effusions. Low levels of B lymphocytes is another characteristic finding. Presence of high levels of B lymphocytes in pleural fluids may be seen in B cell neoplasm such as Burkitt's lymphoma. 55
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