Delfau-Larue M H, Petrella T, Lahet C, Lebozec C, Bagot M, Roudot-Thoraval F, Dalac S, Farcet J P, Wechsler J
Service d'Immunologie Biologique, Hôpital Henri-Mondor, Créteil, France.
J Pathol. 1998 Feb;184(2):185-90. doi: 10.1002/(SICI)1096-9896(199802)184:2<185::AID-PATH997>3.0.CO;2-9.
Histological features of early mycosis fungoides (MF) can simulate numerous inflammatory lesions and histological confirmation of MF is often delayed, compared with clinical diagnosis. Recently, using molecular techniques, the detection of a dominant T-lymphocyte clone has been reported in cutaneous lesions of MF. The aim of the present study was to determine the diagnostic value of a dominant T-lymphocyte clone as assessed by PCR-DGGE in early MF. Histopathological and molecular analyses were performed on cutaneous lesions from 104 patients clinically suspected as having MF. In this population, the positive predictive value of a PCR gamma(+) was 0.86. In addition, four of six patients whose lesions were PCR gamma(+) (detectable dominant T-cell clone) but not histologically MF progressed to MF within 2-48 months. In order to evaluate the relevance of PCR gamma-DGGE in MF follow-up, serial biopsies were performed in 24 patients. In 89 per cent of cases, the presence or absence of a PCR gamma(+) was constant during the course of the disease. When present, the DGGE imprint of PCR products was case-specific. These data demonstrate the diagnostic value in MF of T-lymphocyte clonality assessed by PCR gamma-DGGE on cutaneous lesions and show that the technique can be used in MF follow-up to evaluate residual disease with high specificity.
蕈样肉芽肿（MF）早期的组织学特征可模拟多种炎症性病变，与临床诊断相比，MF的组织学确诊往往延迟。最近，利用分子技术，在MF的皮肤病变中已报道检测到优势T淋巴细胞克隆。本研究的目的是确定通过PCR-DGGE评估的优势T淋巴细胞克隆在早期MF中的诊断价值。对104例临床疑似MF患者的皮肤病变进行了组织病理学和分子分析。在该人群中，PCRγ(+)的阳性预测值为0.86。此外，6例病变PCRγ(+)（可检测到优势T细胞克隆）但组织学上不是MF的患者中有4例在2至48个月内进展为MF。为了评估PCRγ-DGGE在MF随访中的相关性，对24例患者进行了系列活检。在89%的病例中，疾病过程中PCRγ(+)的有无是恒定的。当存在时，PCR产物的DGGE印记是病例特异性的。这些数据证明了通过对皮肤病变进行PCRγ-DGGE评估T淋巴细胞克隆性在MF中的诊断价值，并表明该技术可用于MF随访以高度特异性地评估残留疾病。
