Department of Internal Medicine, Hematology-Oncology Division, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan.
Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan.
J Clin Pathol. 2024 Oct 20;77(11):743-750. doi: 10.1136/jcp-2023-208932.
Angioimmunoblastic T cell lymphoma (AITL) is a T cell lymphoma with aberrant immune activity. It is characterised by inflammatory and immune reactions. However, the impact of regulatory T (Treg) cells on AITL remains unclear.
We retrospectively collected 46 AITL cases and performed immunohistochemical analysis of forkhead box P3 (FOXP3) expression. The number of immunostained FOXP3 cells was determined using a digital pathology system with whole-slide imaging. The average number of FOXP3+ cells per high-power field (HPF) was determined by randomly counting 20 HPFs. AITL cases were categorised into high-expression and low-expression groups based on the median count of FOXP3+ cells in all analysed samples. The relationship between FOXP3 expression and clinicopathological features was assessed.
Among the studied patients, 14 (30.4%) were females and 32 (69.6%) were males, and the median age at diagnosis was 64.1 years. The median expression of FOXP3 was 84.9 positive cells/HPF. FOXP3 expression negatively correlated with Epstein-Barr virus-encoded small RNA positivity in tumour (p=0.041). The patients with low FOXP3 expression presented with aggressive clinical behaviour, including advance-staged diseases (p=0.043), splenomegaly (p=0.008), B symptoms (p=0.019) and extranodal involvement (p=0.019). The neutrophil-to-lymphocyte ratio was higher in the patients with low FOXP3 expression, compared with those with high FOXP3 expression. Low FOXP3 expression had an adverse effect on progression-free survival (PFS, p=0.033), and increased the risk of recurrence 2.320-fold (HR 2.320 (95% CI 1.109 to 4.856); p=0.025).
Patients with AITL with low FOXP3 expression tend to have aggressive clinical presentation and shortened PFS. These findings may help with risk stratification and determination of new treatment strategy.
血管免疫母细胞性 T 细胞淋巴瘤（AITL）是一种具有异常免疫活性的 T 细胞淋巴瘤。其特征为炎症和免疫反应。然而，调节性 T（Treg）细胞对 AITL 的影响尚不清楚。
我们回顾性收集了 46 例 AITL 病例，并进行了叉头框 P3（FOXP3）表达的免疫组织化学分析。使用具有全切片成像的数字病理学系统确定免疫染色 FOXP3 细胞的数量。通过随机计数 20 个高倍视野（HPF）确定每个 HPF 中 FOXP3+细胞的平均数量。根据所有分析样本中 FOXP3+细胞的中位数，将 AITL 病例分为高表达和低表达组。评估 FOXP3 表达与临床病理特征之间的关系。
在所研究的患者中，14 例（30.4%）为女性，32 例（69.6%）为男性，诊断时的中位年龄为 64.1 岁。FOXP3 的中位表达为 84.9 个阳性细胞/HPF。FOXP3 表达与肿瘤中 EBV 编码的小 RNA 阳性呈负相关（p=0.041）。FOXP3 低表达的患者表现出侵袭性临床行为，包括晚期疾病（p=0.043）、脾肿大（p=0.008）、B 症状（p=0.019）和结外累及（p=0.019）。FOXP3 低表达的患者中性粒细胞与淋巴细胞比值较高，与 FOXP3 高表达的患者相比。FOXP3 低表达对无进展生存期（PFS，p=0.033）有不良影响，使复发风险增加 2.320 倍（HR 2.320（95%CI 1.109 至 4.856）；p=0.025）。
FOXP3 低表达的 AITL 患者倾向于表现出侵袭性的临床特征和较短的 PFS。这些发现可能有助于风险分层和确定新的治疗策略。
