单核细胞HLA-DR和CD16检测在炎症性疾病中的应用价值

doi:10.3969/j.issn.1673-8640.2018.09.001

摘要/Abstract

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。

关键词: 人白细胞抗原-DR, CD16, 单核细胞, 炎症性疾病

Abstract:

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.

Key words: Human leukocyte antigen-DR, CD16, Monocyte, Inflammatory disease

中图分类号:

R446.1

章黎华, 王维维, 张良, 沈立松. 单核细胞HLA-DR和CD16检测在炎症性疾病中的应用价值[J]. 检验医学, 2018, 33(9): 775-780.

ZHANG Lihua, WANG Weiwei, ZHANG Liang, SHEN Lisong. Role of monocytic HLA-DR and CD16 determinations in inflammatory diseases[J]. Laboratory Medicine, 2018, 33(9): 775-780.

图/表 6

参考文献 18

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组别	例数	NEUT#（×10⁹/L）	NEUT% （%）	LYMPH#（×10⁹/L）	LYMPH%（%）	NLR	MO# （×10⁹/L）	MO% （%）
炎症性疾病组	56	9.68 ± 4.27^*	82.25 ± 7.08^*	1.04 ± 0.50^*	9.83 ± 4.63^*	10.79 ± 6.12^*	0.77 ± 0.33^*	7.02 ± 3.44
正常对照组	40	3.45 ± 0.88	58.09 ± 5.94	1.93 ± 0.38	33.23 ± 6.05	1.86 ± 0.64	0.36 ± 0.09	6.09 ± 1.27

组别	例数	NEUT#（×10⁹/L）	NEUT% （%）	LYMPH#（×10⁹/L）	LYMPH%（%）	NLR	MO# （×10⁹/L）	MO% （%）
炎症性疾病组	56	9.68 ± 4.27^*	82.25 ± 7.08^*	1.04 ± 0.50^*	9.83 ± 4.63^*	10.79 ± 6.12^*	0.77 ± 0.33^*	7.02 ± 3.44
正常对照组	40	3.45 ± 0.88	58.09 ± 5.94	1.93 ± 0.38	33.23 ± 6.05	1.86 ± 0.64	0.36 ± 0.09	6.09 ± 1.27

组别	例数	HLA-DR MFI	HLA-DR⁺%（%）	HLA-DR⁺MFI	CD16 MFI	CD16⁺ %（%）	CD16⁺MFI
炎症性疾病组	56	1 426 ± 733^*	71.44 ± 21.15^*	1 823 ± 568^*	467 ± 237^*	18.14 ± 13.70^*	3 272 ± 1 753^*
正常对照组	40	3 805 ± 1 266	98.69 ± 2.12	3 838 ± 1 250	155 ± 48	9.59 ± 4.74	871 ± 256

组别	例数	HLA-DR MFI	HLA-DR⁺%（%）	HLA-DR⁺MFI	CD16 MFI	CD16⁺ %（%）	CD16⁺MFI
炎症性疾病组	56	1 426 ± 733^*	71.44 ± 21.15^*	1 823 ± 568^*	467 ± 237^*	18.14 ± 13.70^*	3 272 ± 1 753^*
正常对照组	40	3 805 ± 1 266	98.69 ± 2.12	3 838 ± 1 250	155 ± 48	9.59 ± 4.74	871 ± 256

项目	NEUT#	NEUT%	LYMPH#	LYMPH%	NLR	MO#	MO%
HLA-DR MFI
r值	-0.696	-0.729	0.533	0.706	-0.711	-0.476	0.087
P值	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	>0.05
HLA-DR⁺%
r值	-0.740	-0.754	0.539	0.745	-0.751	-0.511	0.102
P值	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	>0.05
HLA-DR⁺ MFI
r值	-0.649	-0.688	0.489	0.650	-0.657	-0.427	0.104
P值	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	>0.05
CD16 MFI
r值	0.503	0.505	-0.469	-0.556	0.549	0.499	0.174
P值	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	>0.05
CD16⁺%
r值	0.208	0.174	-0.240	-0.266	0.250	0.354	0.261
P值	<0.05	>0.05	<0.05	<0.01	<0.05	<0.01	<0.05
CD16⁺MFI
r值	0.603	0.652	-0.553	-0.646	0.645	0.531	0.131
P值	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	>0.05