DETECTION OF PERFORIN IN HUMAN PERITONEAL-FLUID T-LYMPHOCYTES

OBJECTIVE: Perforin is a specific marker of functionally active cytoto xic T-lymphocytes (CTLs) and natural killer (NK) cells. The purpose of this study was to detect perforin-positive lymphocytes in ascites sec ondary to various gynecologic malignancies and nonneoplastic condition s. STUDY DESIGN: Fifty-three unselected peritoneal fluid specimens sub mitted for cytopathologic diagnosis were used. A monoclonal antibody t o human perforin was used to examine its expression in mononuclear cel ls from ascites specimens using a standard immuno-peroxidase technique . RESULTS: Strong preforin expression by 15-30% of mononuclear cells w as detected in 10 of the 13 patients with severe alcoholic hepatitis, 3 of the 5 patients with severe alcoholic hepatitis, 3 of the 5 patien ts with chronic active hepatitis without cirrhosis and 1 patient with an autoimmune disorder of unknown etiology. The lymphocytes showed var iable positivity for T cell markers (CD2, CD4, CD8 and CD56). Perforin was not detected in ascites specimens obtained from patients with suc h nonneoplastic disorders as cirrhosis or end stage renal or cardiac f ailure. Similarly, ascites specimens from patients with various gyneco logic malignancies were negative for perforin-positive lymphocytes. CO NCLUSION: The detection of cytotoxic lymphocytes in peritoneal fluid o btained from patients with liver injury may have implication for the p athogenesis of this disease.