Analysis for the immunity inflammatory responses and blood coagulation indexes in patients with pulmonary tuberculosis complicated by lung cancer

doi:10.3969/j.issn.1002-7386.2018.03.014

Abstract：Objective To investigate the characteristics of immunity inflammatory responses and blood coagulation indexes in patients with pulmonary tuberculosis complicated by lung cancer in order to provide a basis for further treatment.Methods Sixty-five patients with pulmonary tuberculosis complicated by lung cancer who were dagnosed in our hospital from May 2012 and to October 2015 were enrolled in the study.According to the NCCN lung cancer clinical stages these patients were divided into two subgroups,stage Ⅰ ～ Ⅱ group and stage Ⅲ ～ Ⅳ group,at the same time,the other 60 patients with simple pulmonary tuberculosis were served as control group.The proportions of CD3+,CD4+,CD8+,Th1,Th2,Th17,and Treg (CD4+CD25+) were detected by flow cytometry to calculate the ratios of CD4+/CD8+,Th1/Th2 and Th17/Treg in peripheral blood of patients.Moreover the serum levels of interleukin-2,interleukin-10,interluken-17,and TGF-3 were measured by enzyme-linked immunoassay (ELISA),and the plasma levels of D-dimer were detected by immunoturbidimetry.In addition all the patients were examined by pulmonary artery CTA,and the incidence rates of symptomatic pulmonary embolism and arterial thrombosis ir pulmonary segment and sub-pulmonary segment were observed and compared among the three groups.Results The proportions of CD3+,CD4+,and the ratios of CD:/CD8+,Th1/Th2 and Th17/Treg were gradually decreased in order of stage Ⅰ ～ Ⅱ group,stage Ⅲ ～ Ⅳ group,control group,there were significant differences among the three groups (P ＜0.05),in which there were no significant differences in proportion of CD3+,CD:,and ratio of CD4+/CD8+ between stage Ⅰ ～ Ⅱ group and control group (P ＞ 0.05),however,the ratios of Th1/Th2,Th17/Treg were significantly decreased (P ＜0.05).The levels of IL-2,IL-17 were gradually decreased in order of stage Ⅰ ～ Ⅱ group,stage Ⅲ ～ Ⅳ group,however,the levels of IL-10,TGF-β were gradually increased,there were significant differences between two groups (P ＜ 0.05).In addition the positive rate of D-dimer and incidence rate of symptomatic pulmonary embolism in stage Ⅲ ～ Ⅳ group were significantly higher than those in the other two groups (P ＜ 0.05).However,there were no significant differences between control group and stage Ⅰ ～ Ⅱ group (P ＞ 0.05).Moreover the levels of D-dimer and incidence rates of arterial thrombosis in pulmonary segment without symptoms and sub-pulmonary segment were gradually increased in order of control group,stage Ⅰ ～ Ⅱ group,stage Ⅲ ～ Ⅳ group,there were significant differences among groups and between two groups each other (P ＜ 0.05).Conclusion The decrease of cellular immune function and disbalance are observed in patients with pulmonary tuberculosis complicated by lung cancer,with the probability of incidence of pulmonary embolism being increased.