Hiyoshi Saaya, Ohno Koichi, Uchida Kazuyuki, Goto-Koshino Yuko, Nakashima Ko, Fukushima Kenjiro, Kanemoto Hideyuki, Maeda Shingo, Tsujimoto Hajime
Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan.
Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan.
Vet Immunol Immunopathol. 2015 Jun 15;165(3-4):138-44. doi: 10.1016/j.vetimm.2015.03.009. Epub 2015 Apr 6.
Although definitive diagnosis of chronic enteropathy (CE) and gastrointestinal (GI) lymphoma requires histopathological evaluation of the GI tract, these conditions are often still difficult to differentiate from each other. Polymerase chain reaction (PCR) for antigen receptor gene rearrangements (PARR) has been applied recently as an adjunctive for diagnosis of lymphoid tumors; however, its clinical value in canine CE and GI lymphoma remains unclear. The purpose of this study was to investigate the relationship between PARR and histopathological diagnosis, degree of enteritis or lymphoma, and long-term prognosis in dogs, in order to evaluate the clinical significance of PARR. Endoscopic biopsy specimens obtained from 96 dogs with chronic enteritis (mild, n=14; moderate, n=20; marked, n=62) and 21 dogs with GI lymphoma were used. Clonality was observed in 51% of the animals with chronic enteritis; interestingly, it was found in 29% of those with only mild enteritis. In dogs with marked enteritis, the rate of PARR was higher in those with lymphocyte epitheliotropism than in those without epitheliotropism. The sensitivity of PARR in animals with GI lymphoma was 76%. There was no significant prognostic difference between chronic enteritis with or without clonal rearrangements. In contrast, dogs histopathologically diagnosed with marked enteritis had a significantly shorter survival time than did those with mild or moderate enteritis. While the significance of PARR in the diagnosis of GI lymphoma remains uncertain, the pathological roles of clonally expanding lymphocytes in canine CE should be investigated further.
尽管慢性肠病（CE）和胃肠道（GI）淋巴瘤的确诊需要对胃肠道进行组织病理学评估，但这些病症往往仍难以相互区分。用于抗原受体基因重排（PARR）的聚合酶链反应（PCR）最近已被用作淋巴肿瘤诊断的辅助手段；然而，其在犬类CE和GI淋巴瘤中的临床价值仍不明确。本研究的目的是调查PARR与组织病理学诊断、肠炎或淋巴瘤程度以及犬类长期预后之间的关系，以评估PARR的临床意义。使用了从96只患有慢性肠炎（轻度，n = 14；中度，n = 20；重度，n = 62）的犬和21只患有GI淋巴瘤的犬获得的内镜活检标本。在51%的慢性肠炎动物中观察到克隆性；有趣的是，在仅患有轻度肠炎的动物中，这一比例为29%。在患有重度肠炎的犬中，具有淋巴细胞亲上皮性的犬的PARR率高于无亲上皮性的犬。PARR在患有GI淋巴瘤的动物中的敏感性为76%。有或无克隆重排的慢性肠炎之间在预后方面没有显著差异。相比之下，组织病理学诊断为重度肠炎的犬的生存时间明显短于轻度或中度肠炎的犬。虽然PARR在GI淋巴瘤诊断中的意义仍不确定，但克隆性扩增淋巴细胞在犬类CE中的病理作用应进一步研究。
