免疫表型分析和T细胞受体γ基因重排分析作为蕈样肉芽肿组织病理学诊断的辅助手段。
Immunophenotyping and T-cell receptor gamma gene rearrangement analysis as an adjunct to the histopathologic diagnosis of mycosis fungoides.
作者信息
Bergman R, Faclieru D, Sahar D, Sander C A, Kerner H, Ben-Aryeh Y, Manov L, Hertz E, Sabo E, Friedman-Birnbaum R
机构信息
Department of Dermatology, Rambam Medical Center, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa.
出版信息
J Am Acad Dermatol. 1998 Oct;39(4 Pt 1):554-9. doi: 10.1016/s0190-9622(98)70003-9.
BACKGROUND
The histopathologic diagnosis of mycosis fungoides (MF) may be difficult.
OBJECTIVE
Our purpose was to evaluate the role of immunophenotyping and T-cell receptor (TCR) gene rearrangement studies as an adjunct to the histopathologic diagnosis of MF.
METHODS
Immunohistochemical studies with antibodies to CD4, CD5, CD7, and CD8 and TCR gamma gene rearrangement analysis with a polymerase chain reaction were performed on fresh-frozen material of patients with "classic" histology of MF, "inconclusive" histology, and benign inflammatory dermatoses.
RESULTS
Clonal TCR gamma gene rearrangements were found in 11 of 16 (69%) of classic MF cases, in 3 of 19 (16%) of inconclusive cases, and in none of the 12 inflammatory dermatoses cases (P < .05 and P < .001, respectively). Only the mean CD7 counts were statistically significantly different between these 3 groups (MF < inconclusive < inflammatory).
CONCLUSION
Inconclusive histology is probably a heterogeneous group in which CD7 counts and TCR gamma gene rearrangement studies might help to differentiate the MF cases from the benign cases.
背景
蕈样肉芽肿（MF）的组织病理学诊断可能存在困难。
目的
我们的目的是评估免疫表型分析和T细胞受体（TCR）基因重排研究作为MF组织病理学诊断辅助手段的作用。
方法
对具有MF“典型”组织学表现、“不确定”组织学表现的患者以及良性炎症性皮肤病患者的新鲜冷冻材料进行抗CD4、CD5、CD7和CD8抗体的免疫组织化学研究，并用聚合酶链反应进行TCRγ基因重排分析。
结果
在16例“典型”MF病例中的11例（69%）、19例“不确定”病例中的3例（16%）以及12例炎症性皮肤病病例中均未发现克隆性TCRγ基因重排（分别为P <.05和P <.001）。这3组之间仅平均CD7计数有统计学显著差异（MF < 不确定 < 炎症）。
结论
“不确定”组织学可能是一个异质性群体，其中CD7计数和TCRγ基因重排研究可能有助于将MF病例与良性病例区分开来。
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