Valeur diagnostique du rapport CD103+CD4+/CD4+ pour différencier la sarcoïdose d'autres causes de lymphocytose alvéolaire.

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State: Public
Version: After imprimatur
Serval ID
serval:BIB_3AE778BD712D
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Valeur diagnostique du rapport CD103+CD4+/CD4+ pour différencier la sarcoïdose d'autres causes de lymphocytose alvéolaire.
Author(s)
BRETAGNE L.
Director(s)
LAZOR R.
Codirector(s)
NICOD L.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2014
Language
english
Number of pages
20
Abstract
Introduction:
CD103 is a specific integrin present on some CD4+ lymphocytes of the mucosal immune system. It has been hypothesized that most CD4+ lymphocytes in pulmonary sarcoidosis do not originate from mucosal sites but from redistribution from the peripheral blood, and therefore do not bear the CD103 integrin. Several studies have suggested that a low CD103+ percentage among bronchoalveolar lavage (BAL) CD4+ lymphocytes discriminates between sarcoidosis and other causes of lymphocytic alveolitis, but contradictory data exist.
Methods:
We reviewed 1151 consecutive patients with BAL lymphocytosis >10% and flow cytometry performed between 2006 and 2014. 944 cases were excluded due to poor BAL quality (n= 97), unavailable clinical data (n= 760), or unclear diagnosis (n= 87). The remaining 207 patients were grouped into 9 diagnostic categories. To assess the discriminative value of the CD103+CD4+/CD4+ ratio to distinguish sarcoidosis from the other entities, area under ROC curves (AUC) were determined.
Results:
Sarcoidosis patients (n=53) had a lower CD103+CD4+/CD4+ ratio than the other diagnostic categories. AUC was 62% for sarcoidosis compared to all other patients and 69% for sarcoidosis compared to other interstitial lung diseases. When combining CD103+CD4+/CD4+ and CD4+/CD8+ ratios, AUC increased to 76% and 78% respectively. When applying published cut-offs from 4 previous studies to our population, AUC varied between 54 and 73%.
Conclusions:
The CD103+CD4+/CD4+ ratio does not accurately discriminate between sarcoidosis and other causes of lymphocytic alveolitis, neither alone nor in combination with CD4+/CD8+ ratio, and is not a relevant marker for the diagnosis of sarcoidosis.
Keywords
Sarcoidosis, CD103, Bronchoalveolar Lavage, Integrin, Lung Diseases, Interstitial, CD4-Positive T-Lymphocyte, Flow Cytometry
Create date
07/09/2015 8:36
Last modification date
20/08/2019 13:30
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