Izban K F, Hsi E D, Alkan S
Department of Pathology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Mod Pathol. 1998 Oct;11(10):978-82.
Mycosis fungoides (MF) is typically characterized by dermal and epidermal infiltration of T lymphocytes with a helper/inducer phenotype. Immunophenotypic analysis of such cases was traditionally performed by flow cytometry or immunohistochemistry on cryostat sections. With the advent of new monoclonal antibodies developed against T-cell antigens, including CD3, CD4, CD5, and CD8, it is now possible to immunophenotype T-cell subpopulations in paraffin-embedded tissues. To investigate the potential use of these antibodies for the evaluation of cutaneous lesions, 35 specimens (34 skin and 1 lymph node) from 29 patients with MF were retrospectively reviewed and immunophenotyped in paraffin sections with antibodies to CD3 (T-cell CD3), CD4 (NCL-CD4-1F6), CD5 (NCL-CD5-4C7), CD8 (CD8/144B), and CD20 (L26). Epidermal and dermal distribution of T and B cells were analyzed, and we assessed the ratios of CD4+ to CD8+ T cells. All of our 35 cases demonstrated a predominant CD3+ T-cell population. In 32 cases, the neoplastic cells expressed CD3, CD4, and CD5 consistent with a T-helper/inducer phenotype. In three cutaneous cases, the neoplastic CD4+ T cells showed minimal or absent expression of CD5, indicating an aberrant phenotype. In the majority of cases, minimal CD8+ T cells were present in the background, but in four cases, the CD4:CD8 ratios were 2:1 or less. Thirty-two cutaneous cases demonstrated epidermotropism exclusively by CD4+ T cells; one case showed both CD4+ and CD8+ T cells. In 17 cutaneous cases, scattered dermal CD20+ B cells were found individually or in small clusters within the background surrounding the neoplastic infiltrates. We concluded, therefore, that the immunophenotypic analysis of T-cell subpopulations using monoclonal antibodies of CD3, CD4, CD5, and CD8 was useful for histologic evaluation and confirmation of MF lesions in paraffin-embedded tissue. These antibodies might also provide an effective method of immunophenotyping other neoplastic and non-neoplastic T-cell populations in paraffin-embedded tissues.
蕈样肉芽肿（MF）的典型特征是具有辅助/诱导表型的T淋巴细胞浸润真皮和表皮。传统上，此类病例的免疫表型分析是通过流式细胞术或对低温恒温器切片进行免疫组织化学来进行的。随着针对T细胞抗原（包括CD3、CD4、CD5和CD8）开发的新型单克隆抗体的出现，现在可以对石蜡包埋组织中的T细胞亚群进行免疫表型分析。为了研究这些抗体在评估皮肤病变中的潜在用途，我们回顾性分析了29例MF患者的35个标本（34个皮肤标本和1个淋巴结标本），并用抗CD3（T细胞CD3）、CD4（NCL-CD4-1F6）、CD5（NCL-CD5-4C7）、CD8（CD8/144B）和CD20（L26）抗体对石蜡切片进行免疫表型分析。分析了T细胞和B细胞在表皮和真皮中的分布情况，并评估了CD4+与CD8+T细胞的比例。我们的35例病例均显示以CD3+T细胞为主。在32例病例中，肿瘤细胞表达CD3、CD4和CD5，符合T辅助/诱导表型。在3例皮肤病例中，肿瘤性CD4+T细胞显示CD5表达极少或无表达，表明存在异常表型。在大多数病例中，背景中存在少量CD8+T细胞，但在4例病例中，CD4:CD8比例为2:1或更低。32例皮肤病例仅显示CD4+T细胞亲表皮现象；1例病例同时显示CD4+和CD8+T细胞。在17例皮肤病例中，在肿瘤浸润灶周围的背景中发现单个或小簇散在的真皮CD20+B细胞。因此，我们得出结论，使用CD3、CD4、CD5和CD8单克隆抗体对T细胞亚群进行免疫表型分析，有助于对石蜡包埋组织中的MF病变进行组织学评估和确诊。这些抗体也可能为石蜡包埋组织中其他肿瘤性和非肿瘤性T细胞群体的免疫表型分析提供一种有效方法。
