流式细胞术在蕈样肉芽肿诊断中的应用价值。
Usefulness of flow cytometry in the diagnosis of mycosis fungoides.
作者信息
Oshtory Shaheen, Apisarnthanarax Narin, Gilliam Anita C, Cooper Kevin D, Meyerson Howard J
机构信息
Department of Dermatology, Ireland Cancer Center of University Hospitals of Cleveland/Case Western Reserve University, Cleveland, Ohio 44106, USA.
出版信息
J Am Acad Dermatol. 2007 Sep;57(3):454-62. doi: 10.1016/j.jaad.2007.01.017.
BACKGROUND
The pathologic evaluation of mycosis fungoides (MF) is a challenging area in dermatopathology.
OBJECTIVE
We sought to determine the usefulness of flow cytometry for the diagnosis of MF from skin biopsy specimens.
METHODS
Skin biopsy specimens from 22 patients with a clinical suggestion for MF were evaluated by 4-color flow cytometry. The results were correlated with the International Society for Cutaneous Lymphoma (ISCL) MF diagnostic score and molecular studies for T-cell receptor gene rearrangement.
RESULTS
A T-cell abnormality by flow cytometry was identified in all 11 patients with diagnostic ISCL scores whereas the 7 patients with either subdiagnostic ISCL scores or reactive histology showed no phenotypic abnormality by flow cytometry. In all, 10 of 11 patients with diagnostic skin biopsy specimens for MF had T-cell receptor gene rearrangements by polymerase chain reaction. Gene rearrangements were not detected in the subdiagnostic group.
LIMITATIONS
Small study size was a limitation.
CONCLUSION
Flow cytometry of skin biopsy specimens is a sensitive method for detecting abnormalities in MF and should be considered part of the routine workup of patients with a clinical suggestion of MF.
背景
蕈样肉芽肿（MF）的病理评估是皮肤病理学中一个具有挑战性的领域。
目的
我们试图确定流式细胞术在皮肤活检标本诊断MF中的实用性。
方法
对22例临床提示为MF的患者的皮肤活检标本进行四色流式细胞术评估。结果与国际皮肤淋巴瘤协会（ISCL）的MF诊断评分以及T细胞受体基因重排的分子研究结果相关。
结果
所有11例诊断为ISCL评分的患者通过流式细胞术均检测到T细胞异常，而7例ISCL评分低于诊断标准或组织学表现为反应性的患者通过流式细胞术未显示表型异常。在所有诊断为MF的皮肤活检标本的11例患者中，有10例通过聚合酶链反应检测到T细胞受体基因重排。在低于诊断标准的组中未检测到基因重排。
局限性
研究样本量小是一个局限。
结论
皮肤活检标本的流式细胞术是检测MF异常的一种敏感方法，应被视为临床提示为MF的患者常规检查的一部分。
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