Lien H C, Lin C W, Huang P H, Chang M L, Hsu S M
Department of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei.
Lab Invest. 2000 Jun;80(6):893-900. doi: 10.1038/labinvest.3780093.
Lymphomas involving the nasal and nasopharyngeal region mainly include CD56-positive natural killer (NK)/T-cell lymphomas, CD56-negative peripheral T-cell lymphomas (PTL), and B-cell lymphomas. Among these, the CD56-positive lymphoma, presumably of an NK/T-cell nature, is frequently seen in Asian, Mexican, and South American patients. NK cells are proposed to be closer developmentally to T cells than to other lymphoid cells, because bipotential common progenitor cells of NK/T-cell lineage have been isolated. In this study, we collected 47 cases of nasal lymphoma and investigated the phenotypic difference between NK/T-cell lymphoma and PTL by examining the pattern of the developmentally differentially expressed molecules cdk6 (cyclin-dependent kinase 6), CD44, CD117, and by examining the rearrangement of the T-cell receptor gene (TcR-GR). cdk6, an essential regulator of the cell cycle in G1 progression, was over-expressed in a subset of cortical thymocytes, but absent in mature thymocytes. In contrast, CD44, a glycosylated adhesion molecule, was absent in cortical thymocytes, but present in mature thymocytes and peripheral activated T cells. We found both over-expression of nuclear cdk6 (n-cdk6) and frequent absence of CD44 in nasal CD56-positive NK/T-cell lymphomas, in contrast to most nasal CD56-negative PTL, which were CD44-immunoreactive with weak or no expression of n-cdk6. Almost all tested cases of NK/T-cell lymphoma displayed a germ-line configuration of TcR, without evidence of gene rearrangement. Thus, there seems to be a useful distinction between the classical NK/T type of nasal lymphoma (CD56+/n-cdk6+/CD44-/TcR-GR-) and PTL (CD56-/n-cdk6-/CD44+/TcR-GR+) involving the nasal region. The presence of Epstein-Barr virus does not seem to be a good marker for distinguishing between NK/T lymphoma and PTL involving the nasal region.
累及鼻腔和鼻咽部的淋巴瘤主要包括CD56阳性的自然杀伤（NK）/T细胞淋巴瘤、CD56阴性的外周T细胞淋巴瘤（PTL）以及B细胞淋巴瘤。其中，推测为NK/T细胞性质的CD56阳性淋巴瘤在亚洲、墨西哥和南美患者中较为常见。由于已分离出NK/T细胞谱系的双能共同祖细胞，因此有人提出NK细胞在发育上比其他淋巴细胞更接近T细胞。在本研究中，我们收集了47例鼻腔淋巴瘤病例，并通过检测发育差异表达分子细胞周期蛋白依赖性激酶6（cdk6）、CD44、CD117的表达模式以及T细胞受体基因（TcR-GR）的重排，研究了NK/T细胞淋巴瘤与PTL之间的表型差异。cdk6是细胞周期G1期进程的重要调节因子，在一部分皮质胸腺细胞中过表达，但在成熟胸腺细胞中不存在。相反，糖基化粘附分子CD44在皮质胸腺细胞中不存在，但在成熟胸腺细胞和外周活化T细胞中存在。我们发现，鼻腔CD56阳性NK/T细胞淋巴瘤中核cdk6（n-cdk6）过表达且CD44常缺失，而大多数鼻腔CD56阴性PTL则CD44免疫反应阳性，n-cdk6表达弱或无表达。几乎所有检测的NK/T细胞淋巴瘤病例均显示TcR的种系构型，无基因重排证据。因此，经典的鼻腔NK/T型淋巴瘤（CD56+/n-cdk6+/CD44-/TcR-GR-）与累及鼻腔的PTL（CD56-/n-cdk6-/CD44+/TcR-GR+）之间似乎存在有用的区分。爱泼斯坦-巴尔病毒的存在似乎不是区分累及鼻腔的NK/T淋巴瘤和PTL的良好标志物。
