Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
Bone Marrow Transplant. 2013 Nov;48(12):1525-9. doi: 10.1038/bmt.2013.105. Epub 2013 Jul 29.
The objective of this study was to test the relationship between histological changes in minor salivary glands (MSG) and chronic GVHD (cGVHD) severity and OS of hematopoietic SCT (HSCT) patients, and to discriminate the participation of events preceding HSCT that damage MSG, from those linked to cGVHD. The MSG of 57 HSCT patients who were divided into two groups-oral cGVHD (36 cases) and non-cGVHD (21 cases)-were compared with the MSG of a control group of 19 non-HSCT individuals. cGVHD changes were assessed according to National Institutes of Health (NIH) consensus and the systems of Horn et al. Acinar areas and mononuclear cell subsets were set through morphometry. Horn's 'periductal lymphocytic infiltrate' correlated with an extensive form of cGVHD and NIH 'periductal lymphocytes with exocytosis into duct' correlated with global survival. Measurements of the acinar area differed between the three groups, being the lowest in cGVHD patients, but also reduced in non-cGVHD patients. Significant differences among CD45, CD45RO, CD4 and CD8 immunomarked cells/mm(2) were found by comparing the two groups of HSCT patients. In brief, periductal lymphocytic infiltrate and exocytosis implies inflammatory activity and, consequently, might reflect the cGVHD status and influence survival. Acini loss in non-cGVHD patients may be due to pre-transplant events, but massive lymphocyte infiltrate is part of the cGVHD process.
本研究旨在检验小唾液腺（MSG）组织学变化与慢性移植物抗宿主病（cGVHD）严重程度和造血干细胞移植（HSCT）患者总生存期（OS）之间的关系，并区分导致 MSG 损伤的移植前事件与与 cGVHD 相关的事件。将 57 例 HSCT 患者分为口腔 cGVHD（36 例）和非 cGVHD（21 例）两组，与 19 例非 HSCT 个体的 MSG 进行比较。根据美国国立卫生研究院（NIH）共识和 Horn 等人的系统评估 cGVHD 变化。通过形态计量学设置腺泡面积和单核细胞亚群。Horn 的“导管周围淋巴细胞浸润”与 cGVHD 的广泛形式相关，而 NIH 的“导管周围淋巴细胞伴向导管内排出”与总生存相关。三组之间的腺泡面积测量值存在差异，cGVHD 患者的最低，而非 cGVHD 患者的也降低。通过比较两组 HSCT 患者，发现 CD45、CD45RO、CD4 和 CD8 免疫标记细胞/mm2 之间存在显著差异。总之，导管周围淋巴细胞浸润和排出提示炎症活性，因此可能反映 cGVHD 状态并影响生存。非 cGVHD 患者的腺泡丢失可能是由于移植前事件引起的，但大量淋巴细胞浸润是 cGVHD 过程的一部分。
