通过多重PCR/异源双链分析皮肤T细胞淋巴瘤(蕈样肉芽肿/Sézary综合征)和良性炎症性疾病患者的T细胞受体γ基因重排:临床、组织学和免疫表现型结果的相关性  

作　　者：Ponti R. Quaglino P. Novelli M. M.G. Bernengo 刘艳 

机构地区：[1]Prof. Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Turin, Via Cherasco 23, 10126, Torino, Italy

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2005年第12期45-46,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Background: A dominant T- cell clone can be detected by polymerase chain reaction (PCR) in 40- 90% of cutaneous samples from patients with cutaneous T- cell lymphoma (CTCL). Materials and methods: From 1996 to 2003 we analysed 547 cutaneous biopsies performed to exclude CTCL (mycosis fungoides, MF/Sé zary syndrome, SS). The final diagnosis was benign inflammatory disease (BID) in 353 samples (64.5% )- and CTCL in 194 (35.5% ). T- cell receptor (TCR)- γ gene rearrangement was studied by using a multiplex PCR/heteroduplex (HD) analysis. The PCR results were correlated with the clinical picture, the histological pattern and the presence of T- cell lineage antigen loss, using univariate and multivariate logistic regression analyses. Objective: To determine the sensitivity and specificity of the multiplex PCR/HD analysis and to identify which are the clinical, histopathological or immunophenotypical features significantly associated with a positive T- cell clonality. Results: A clonality was demonstrated in 83.5% of CTCL and in 2.3% of BID (P < 0.001). A significantly higher percentage of clonal cases was associated with the cutaneous T- score (71.4% in T1, 76.1% in T2 and 100% in nodular and erythrodermic MF samples) and with the presence of a T- cell lineage antigen loss (93.9% vs. 77.4% ). Moreover, clonality was closely related to an increase in the histopathological score (51.3% in the samples with a score < 5, compared with 92% in the lesions with ≥ 5). No significant difference in the percentage of clonal cases was found between T1/T2 and T3/T4 lesions with a histopathological score ≥ 5. The multivariate logistic regression showed that the density and extent of the cell infiltrate, the degree of epidermotropism and the presence of cytological atypia share an independent predictive value for clonality in T1/T2 samples, even if the highest odds ratios (3.6) were associated with the density of the cell infiltrate. The disease course of T1/T2 patients was analysed according to the PCR findings. All the PCR- nBackground: A dominant T- cell clone can be detected by polymerase chain reaction (PCR) in 40- 90% of cutaneous samples from patients with cutaneous T- cell lymphoma (CTCL). Materials and methods: From 1996 to 2003 we analysed 547 cutaneous biopsies performed to exclude CTCL (mycosis fungoides, MF/Sé zary syndrome, SS). The final diagnosis was benign inflammatory disease (BID) in 353 samples (64.5% )- and CTCL in 194 (35.5% ). T- cell receptor (TCR)- γ gene rearrangement was studied by using a multiplex PCR/heteroduplex (HD) analysis. The PCR results were correlated with the clinical picture, the histological pattern and the presence of T- cell lineage antigen loss, using univariate and multivariate logistic regression analyses. Objective: To determine the sensitivity and specificity of the multiplex PCR/HD analysis and to identify which are the clinical, histopathological or immunophenotypical features significantly associated with a positive T- cell clonality. Results: A clonality was demonstrated in 83.5% of CTCL and in 2.3% of BID (P < 0.001). A significantly higher percentage of clonal cases was associated with the cutaneous T- score (71.4% in T1, 76.1% in T2 and 100% in nodular and erythrodermic MF samples) and with the presence of a T- cell lineage antigen loss (93.9% vs. 77.4% ). Moreover, clonality was closely related to an increase in the histopathological score (51.3% in the samples with a score < 5, compared with 92% in the lesions with ≥ 5). No significant difference in the percentage of clonal cases was found between T1/T2 and T3/T4 lesions with a histopathological score ≥ 5. The multivariate logistic regression showed that the density and extent of the cell infiltrate, the degree of epidermotropism and the presence of cytological atypia share an independent predictive value for clonality in T1/T2 samples, even if the highest odds ratios (3.6) were associated with the density of the cell infiltrate. The disease course of T1/T2 patients was analysed according to the PCR findings. All the PCR- n

关 键 词：蕈样肉芽肿 T细胞受体 zary 异源双链分析 基因重排 表现型 细胞克隆 淋巴瘤 预测价值 细胞系 

分 类 号：R739.5[医药卫生—肿瘤]