Pawlaczyk Mariola, Kistowska Magdalena, Poreba Elzbieta, Filas Violetta, Breborowicz Jan, Goździcka-Józefiak Anna
Katedra i Klinika Dermatologii Akademii Medycznej w Poznaniu.
Pol Merkur Lekarski. 2003 Nov;15(89):420-3.
The aim of the study was to evaluate the usefulness of the T-cell receptor (TCR) gamma gene rearrangement analysis in the diagnosis of mycosis fungoides (MF) and Sezary syndrome (SS). The analysis of TCR gamma gene rearrangements was performed in patients with MF/SS in different stages and in subjects with inflammatory dermatoses as the control group, using the method of polymerase chain reaction with subsequent separation of products by temperature gradient gel electrophoresis. Dominant clones with TCR-gamma rearrangement were detected in 86.5% of MF/SS skin biopsies and in 67.5% of MF/SS peripheral blood cells whereas in control group in 12% and 15% respectively. Statistically significant differences were found in the occurrence of clonal T-cells in skin infiltrates between patients with MF/SS and control group. Statistical analysis of TCR-gamma rearrangement in peripheral blood cells did not revealed any differences only in patients with early stage (IA) of MF when compared with inflammatory dermatoses. Detection of T-cell receptor gamma gene rearrangement is a valid supplement to histopathological and immunohistochemical examination in cases suspected of MF/SS however the diagnosis should always be based on the analysis of examinations and clinical stage of patients.
本研究的目的是评估T细胞受体（TCR）γ基因重排分析在蕈样肉芽肿（MF）和塞扎里综合征（SS）诊断中的实用性。采用聚合酶链反应方法，随后通过温度梯度凝胶电泳分离产物，对不同阶段的MF/SS患者以及作为对照组的炎症性皮肤病患者进行TCRγ基因重排分析。在86.5%的MF/SS皮肤活检样本和67.5%的MF/SS外周血细胞中检测到具有TCR-γ重排的优势克隆，而在对照组中，这一比例分别为12%和15%。MF/SS患者与对照组之间，皮肤浸润中克隆性T细胞的发生率存在统计学显著差异。仅在MF早期（IA期）患者与炎症性皮肤病患者之间，外周血细胞中TCR-γ重排的统计分析未显示任何差异。对于疑似MF/SS的病例，检测T细胞受体γ基因重排是组织病理学和免疫组织化学检查的有效补充，然而诊断始终应基于对患者检查结果和临床分期的分析。
