Kikuchi A, Ohata Y, Matsumoto H, Sugiura M, Nishikawa T
Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
Cancer. 1997 Jan 15;79(2):269-74.
Adult T-cell leukemia/lymphoma (ATLL) is a neoplasm of the mature helper T-lymphocyte. Human T-lymphotropic virus type 1 (HTLV-1) has been shown to be the cause of this neoplasm. Recently, however, the HTLV-1 genome has been found in some patients with cutaneous T-cell lymphoma (CTCL), which suggests a causal relation of HTLV-1 to CTCL. Thus, the relation between the HTLV-1 genome and CTCL, as well as the difference between ATLL and CTCL, have come into question.
The authors examined two patients with CTCL whose serum anti-HTLV-1 antibodies were constantly positive. The Southern blot technique, inverse polymerase chain reaction (IPCR), and polymerase chain reaction (PCR) with four sets of primers for gag, pol, env, and pX regions of HTLV-1 were used to clarify the distinctions between ATLL and CTCL.
Clinically, one patient presented with multiple subcutaneous nodules with involvements of the internal organ, and the other patient was typical for mycosis fungoides. No integration of HTLV-1 DNA was detected by IPCR or the Southern blot technique in either patient. PCRs with the four sets of primers were all found to be positive for HTLV-1 except one.
The authors conclude that ATLL should be differentiated from CTCL in view of the responsibility of HTLV-1 for promoting or maintaining CTCL.
成人T细胞白血病/淋巴瘤（ATLL）是成熟辅助性T淋巴细胞的肿瘤。已证实人类嗜T淋巴细胞病毒1型（HTLV-1）是该肿瘤的病因。然而，最近在一些皮肤T细胞淋巴瘤（CTCL）患者中发现了HTLV-1基因组，这提示HTLV-1与CTCL之间存在因果关系。因此，HTLV-1基因组与CTCL之间的关系以及ATLL与CTCL之间的差异成为了问题。
作者检查了两名血清抗HTLV-1抗体持续呈阳性的CTCL患者。采用Southern印迹技术、反向聚合酶链反应（IPCR）以及针对HTLV-1的gag、pol、env和pX区域的四组引物进行聚合酶链反应（PCR），以阐明ATLL和CTCL之间的区别。
临床上，一名患者表现为多个皮下结节并累及内脏器官，另一名患者为蕈样肉芽肿典型病例。两名患者通过IPCR或Southern印迹技术均未检测到HTLV-1 DNA整合。除一组外，四组引物的PCR检测均发现HTLV-1呈阳性。
作者得出结论，鉴于HTLV-1在促进或维持CTCL中的作用，应将ATLL与CTCL区分开来。
