Soares A B, Faria P R, Magna L A, Correa M E P, de Sousa C A, Almeida O P, Cintra M L
Department of Oral Pathology, State University of Campinas, Campinas-SP, Brazil.
J Oral Pathol Med. 2005 Jul;34(6):368-73. doi: 10.1111/j.1600-0714.2005.00322.x.
Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells.
Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining.
The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands.
Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.
移植物抗宿主病（GVHD）是接受异基因骨髓移植（BMT）患者发病和死亡的主要原因。我们研究的目的是确定25例患者口腔黏膜和小唾液腺中诊断慢性移植物抗宿主病（cGVHD）最相关的组织学特征，并评估炎症细胞的免疫表型。
选择16例接受异基因BMT但未出现cGVHD的患者作为对照组。对切片进行苏木精-伊红（H&E）染色以及CD68、CD45、CD4、CD8、CD20染色研究。
cGVHD诊断当天口腔黏膜最常见的组织学表现为：上皮基底层水样变性、凋亡小体、淋巴细胞浸润以及上皮与结缔组织之间的局灶性或完全分离。在唇唾液腺（LSG）中，淋巴细胞浸润、腺泡丢失和纤维化是主要改变。细胞毒性CD8-T细胞和巨噬细胞在上皮、结缔组织以及小唾液腺中均占主导地位。
组织学特征有助于口腔cGVHD的诊断。提示CD8-T细胞和巨噬细胞在该病的发病机制中起重要作用。
