IgA表达的免疫组织化学分析可将IgG4相关性疾病与浆细胞型Castleman病区分开来。

Immunohistochemical analysis of IgA expression differentiates IgG4-related disease from plasma cell-type Castleman disease.

作者信息

Manabe Akihiro, Igawa Takuro, Takeuchi Mai, Gion Yuka, Yoshino Tadashi, Sato Yasuharu

机构信息

Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.

Department of Clinical Laboratory, Fukuyama City Hospital, Fukuyama, Japan.

出版信息

Med Mol Morphol. 2017 Mar;50(1):34-41. doi: 10.1007/s00795-016-0145-4. Epub 2016 Jul 20.

DOI:10.1007/s00795-016-0145-4

Abstract

Plasma cell-type Castleman disease (PCD) is often encountered when differentiating IgG4-related disease (IgG4-RD). Given that serum IgA is often elevated in Castleman disease, we investigated whether IgA expression levels in histological specimens can be used to differentiate between the two diseases. Lymph node lesions obtained from 12 IgG4-RD and 11 PCD patients were analysed by immunohistochemistry with anti-IgG, -IgG4, and -IgA antibodies. In addition to all 12 cases of IgG4-RD, 8/11 cases (72.7 %) of PCD also met the diagnostic criteria of IgG4-RD (serum IgG4 ≥135 mg/dl and IgG4/IgG-positive cells ≥40 %). IgA-positive cells were sparsely and densely distributed in IgG4-RD and PCD cases, respectively. The median number of IgA-positive cells ± SD in all 12 cases of IgG4-RD was 31 ± 37 cells per three high-powered fields (3HPFs) (range 4-118 cells/3HPFs). In contrast, the median number of IgA-positive cells, which was significantly higher in all 11 cases of PCD, was 303 ± 238 cells/3HPFs (range 74-737 cells/3HPFs) (P < 0.001). In conclusion, our findings indicate that in cases where serum analysis-based data are unavailable, anti-IgA immunostaining can be used for differential diagnosis of IgG4-RD.

摘要

在鉴别IgG4相关性疾病（IgG4-RD）时，常遇到浆细胞型Castleman病（PCD）。鉴于Castleman病患者血清IgA常升高，我们研究了组织学标本中IgA表达水平是否可用于区分这两种疾病。采用抗IgG、抗IgG4和抗IgA抗体免疫组化分析12例IgG4-RD患者和11例PCD患者的淋巴结病变。除12例IgG4-RD全部符合外，11例PCD中有8例（72.7%）也符合IgG4-RD的诊断标准（血清IgG4≥135mg/dl且IgG4/IgG阳性细胞≥40%）。IgA阳性细胞在IgG4-RD和PCD病例中分别呈稀疏和密集分布。12例IgG4-RD患者中，每三个高倍视野（3HPFs）中IgA阳性细胞的中位数±标准差为31±37个细胞（范围4-118个细胞/3HPFs）。相比之下，11例PCD患者中IgA阳性细胞的中位数显著更高，为303±238个细胞/3HPFs（范围74-737个细胞/3HPFs）（P<0.001）。总之，我们的研究结果表明，在无法获得基于血清分析的数据时，抗IgA免疫染色可用于IgG4-RD的鉴别诊断。