Mao Z Jenny, Surowiecka Maria, Linden Michael A, Singleton Timothy P
Hematopathology Laboratory, University of Minnesota Medical Center, Fairview, Minneapolis, Minnesota.
Cytometry B Clin Cytom. 2015 May-Jun;88(3):190-3. doi: 10.1002/cyto.b.21229. Epub 2015 Apr 7.
Analysis for 24 variable regions of the T-cell-receptor beta chain by flow cytometry (Vbeta) is a new technique to detect clonal alpha-beta T lymphocytes and is characteristically performed on peripheral blood. Angioimmunoblastic T-cell lymphoma (AITL) has increased neoplastic follicular-helper T cells (FHT), which often express CD10; but nonneoplastic, CD10-positive T cells may be associated with reactive lymphadenopathy and with B-cell lymphomas. This study documents the utility of Vbeta analysis of FHT in specimens of AITL from blood, from marrow, and from lymph nodes.
The electronic medical record in the flow cytometry laboratory was searched for specimens that were analyzed by flow cytometry for Vbeta and that were involved by AITL. Flow cytometry was performed for the following antigens: T-cell-associated proteins, CD10, CD56, CD94, CD161, killer-cell immunoglobulin-like receptors, alpha-beta T-cell receptor, gamma-delta T-cell receptor, and Vbeta.
Five patients had six specimens of blood (two), of bone marrow (one), or of lymph nodes (three). Immunophenotypic aberrances were detected for antigens: CD2 (2/6), CD3 (6/6), CD4 (1/6), CD5 (1/6), CD7 (5/6), and CD45 (2/6). All abnormal T-cell populations expressed CD4, and most expressed CD10 (5/6). Four specimens were clonally restricted for Vbeta. Two specimens lacked the alpha-beta T-cell receptor and Vbeta.
Vbeta analysis by flow cytometry can be used to detect clonal alpha-beta FHT in AITL, which may be difficult to diagnose with early involvement. Abnormal Vbeta expression on CD10-positive T cells confirms that FHT are the neoplastic cells.
通过流式细胞术分析T细胞受体β链的24个可变区（Vβ）是一种检测克隆性α-β T淋巴细胞的新技术，其典型操作是对外周血进行检测。血管免疫母细胞性T细胞淋巴瘤（AITL）中肿瘤性滤泡辅助性T细胞（FHT）增多，这些细胞常表达CD10；但非肿瘤性CD10阳性T细胞可能与反应性淋巴结病及B细胞淋巴瘤有关。本研究记录了对AITL患者血液、骨髓和淋巴结标本中FHT进行Vβ分析的应用价值。
在流式细胞术实验室的电子病历中搜索经流式细胞术分析Vβ且与AITL相关的标本。对以下抗原进行流式细胞术检测：T细胞相关蛋白、CD10、CD56、CD94、CD161、杀伤细胞免疫球蛋白样受体、α-β T细胞受体、γ-δ T细胞受体和Vβ。
5例患者有6份标本，分别为血液标本2份、骨髓标本1份、淋巴结标本3份。检测到以下抗原的免疫表型异常：CD2（2/6）、CD3（6/6）、CD4（1/6）、CD5（1/6）、CD7（5/6）和CD45（2/6）。所有异常T细胞群体均表达CD4，大多数表达CD10（5/6）。4份标本的Vβ呈克隆性受限。2份标本缺乏α-β T细胞受体和Vβ。
流式细胞术的Vβ分析可用于检测AITL中克隆性α-β FHT，早期受累时可能难以诊断。CD10阳性T细胞上异常的Vβ表达证实FHT是肿瘤细胞。
