副银屑病皮损及外周血TCRγ基因重排的检测及其临床意义探讨  

Detection of TCRγ gene rearrangements in skin lesions and peripheral blood of patients with parapsoriasis ;and their clinical significance

作　　者：王晓明[1] 薛峰[1] 郑捷[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院皮肤科,200025

出　　处：《中华皮肤科杂志》2016年第8期568-572,共5页Chinese Journal of Dermatology

摘　　要：目的：检测副银屑病患者皮损及外周血TCRγ基因重排并探讨其临床意义。方法20例副银屑病患者，采用BIOMED-2多重PCR扩增体系检测其皮肤及外周血TCRγ链基因重排，分析TCRγ基因重排与患者一般资料、临床类型、组织病理表现（非特异表现和非典型表现）的相关性。结果20例副银屑病患者皮损中，7例TCRγ基因重排阳性。11例外周血TCRγ基因重排检测中3例阳性，其中2例皮损检测亦阳性。皮损及外周血TCRγ基因重排与患者性别、年龄、病程、临床类型均无关（P〉0.05），而皮损TCRγ基因重排阳性与蕈样肉芽肿相关不典型表现有关（P〈0.05）。20例患者平均随访（44.85＆#177;18.48）个月，1例进展为蕈样肉芽肿，2例痊愈。结论副银屑病患者皮损TCRγ基因重排阳性可能与蕈样肉芽肿相关不典型表现有关，结合组织病理不典型表现，提示有进展为蕈样肉芽肿的可能。Objective To detect TCRγ gene rearrangements in skin lesions and peripheral blood of patients with parapsoriasis, and to study their clinical significance. Methods Totally, 20 patients with parapsoriasis were included in this study. BIOMED-2 multiplex PCR was performed to detect TCRγgene rearrangements in lesional skin （n=20）and peripheral blood（n=11）samples from the patients with parapsoriasis. Statistical analysis was performed to assess the relationship of TCRγ gene rearrangements with clinical types of parapsoriasis as well as general information and histopathological manifestations（including non-specific manifestations and atypical manifestations）of patients. Results TCRγ gene rearrangements were positive in lesional skin from 7 of the 20 patients, in peripheral blood from 3 of 11 patients, and in both lesional skin and peripheral blood from 2 patients. Positive TCRγ gene rearrangements in skin lesions were significantly correlated with mycosis fungoides（MF）-related atypical histopatho-logical manifestations（P〈0.05）, but those in neither skin lesions nor peripheral blood were correlated with gender and age of patients or clinical course and types of parapsoriasis（all P〉0.05）. During an average follow-up time of 44.85 ＆#177; 18.48 months, 1 case progressed into MF, and 2 were cured. Conclusions Positive TCRγgene rearrangements in skin lesions of patients with parapsoriasis may be correlated with MF-related atypical manifestations. The presence of TCRγgene rearrangements and atypical histopathological manifestations may suggest the possibility of progression from parapsoriasis into MF.

关 键 词：类银屑病 基因重排 γ链T细胞抗原受体 蕈样真菌病 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]