皮肤T细胞淋巴瘤外周血淋巴细胞免疫表型的变化及其意义  

Change and significance of peripheral blood lymphocyte immunophenotype in cutaneous T-cell lymphoma

作　　者：由然[1] 龚岩[1] 屈晨雪[1] 汪旸[2] 袁家颖[1] 陆遥[1] 汤晓凌[1] 

机构地区：[1]北京大学第一医院检验科,北京100034 [2]北京大学第一医院皮肤科,北京100034

出　　处：《检验医学》2016年第3期195-200,共6页Laboratory Medicine

摘　　要：目的探讨外周血淋巴细胞免疫表型分析在皮肤T细胞淋巴瘤中的应用价值。方法采用流式细胞术检测52例确诊皮肤疾病患者[包括31例皮肤T细胞淋巴瘤(恶性皮肤病组)、21例炎症性皮肤病(良性皮肤病组)]外周血淋巴细胞免疫表型并进行形态学检查。比较良性和恶性皮肤病淋巴细胞亚群、免疫表型特点及其外周血形态学特点。结果恶性皮肤病组CD4/CD8双阴性T淋巴细胞明显高于良性皮肤病组(P<0.05),而恶性皮肤病组B淋巴细胞百分比明显低于良性皮肤病组(P<0.05)。恶性皮肤病组中Sézary综合征亚组T淋巴细胞百分比、CD4/CD8比值以及CD4/CD8双阴性T淋巴细胞百分比高于其他恶性皮肤病亚组以及良性皮肤病组(P<0.05),B淋巴细胞和自然杀伤(NK)细胞百分比降低(P<0.05)。恶性皮肤病组中有14例(45.1%)免疫表型异常,有15例(48.4%)外周血淋巴细胞形态异常;良性皮肤病组中有5例(23.8%)免疫表型异常,有6例(28.6%)外周血淋巴细胞形态异常。结论外周血淋巴细胞免疫表型分析可为皮肤T细胞淋巴瘤的临床诊断提供佐证,有助其鉴别诊断。Objective To investigate the application significance of peripheral blood lymphocyte immunophenotype in cutaneous T-cell lymphoma. Methods Peripheral blood lymphocyte immunophenotype was analyzed by flow cytometry and morphology in 52 patients diagnosed as skin disorders [31 cases of cutaneous T-cell lymphoma（malignant skin disorder group）and 21 cases of inflammatory skin disorders（benign skin disorder group）]. The characteristics of lymphocyte subset,immunophenotype and morphology between benign and malignant skin disorder groups were compared. Results CD4/CD8 double negative T lymphocyte in malignant group was significantly higher than that in benign group（P〈0.05）,and B lymphocyte percentage in malignant group was significantly lower than that in benign group（P〈0.05）. In malignant group,T lymphocyte percentage,CD4/CD8 ratio and CD4/CD8 double negative T lymphocyte percentage in Sézary syndrome subgroup were higher than those in benign group and other malignant skin disorder subgroups（P〈0.05）,meanwhile B lymphocyte and natural killer（NK） cell percentage decreased（P〈0.05）. There were 14 abnormal cases of malignant group（45.1%）and 5 abnormal cases of benign group（23.8%） for immunophenotype. There were 15 abnormal cases of malignant group（48.4%） and 6 abnormal cases of benign group（28.6%）for morphology. Conclusions Peripheral blood lymphocyte immunophenotype can provide a reference for the diagnosis of cutaneous T-cell lymphoma,and it is helpful with the differential diagnosis.

关 键 词：皮肤T细胞淋巴瘤 淋巴细胞 免疫表型 

分 类 号：R446.11[医药卫生—诊断学]