鼻型结外NK/T细胞淋巴瘤临床病理分析  

Extranodal NK/T cell lymphoma nasal type:a clinicopathological analysis

作　　者：王素芬[1] 刘萍 卢林明[3] 徐五琴 刘霞[1] 刘银华[1] WANG Su-fen;LIU Ping;LU Lin-ming;XU Wu-qin;LIU Xia;LIU Yin-hua(Department of Pathology,Yijishan Hospital of Wannan Medical College,Wuhu241000,China;Department of Pathology,People’s Hospital of Guangde,Guangde242200,China;Department of Pathology,Wannan Medical College,Wuhu241000,China)

机构地区：[1]皖南医学院弋矶山医院病理科,芜湖241000 [2]安徽省广德市人民医院病理科,广德242200 [3]皖南医学院病理教研室,芜湖241000

出　　处：《临床与实验病理学杂志》2020年第5期529-533,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：2018年度安徽高校自然科学研究重点项目(KJ2018A0250);皖南医学院弋矶山医院科研能力“高峰”培育计划(GF2019G19)。

摘　　要：目的探讨鼻型结外NK/T细胞淋巴瘤(extranodal NK/T-cell lymphoma,ENKTL)的临床病理特征、治疗及预后。方法采用免疫组化EnVision两步法检测55例ENKTL中CK(AE1/AE3)、EMA、CD20、CD79a、CD3、CD43、CD4、CD8、CD56、TIA-1、perforin、Granzyme B(GrB)、Ki-67的表达,并复习相关文献。结果55例ENKTL患者中,男性36例,女性19例,年龄22~80岁,中位年龄57岁;发生部位以鼻腔、鼻咽部最多见,其次好发于皮肤。免疫组化标记CD3最敏感,CD56、TIA-1、perforin、GrB均阳性,显色原位杂交(chromogenic in situ hybridization,CISH)检测示55例EBER阳性(100%)。27例患者有随访,其中11例死亡(生存时间1~68个月),中位生存时间15个月。结论鼻型ENKTL好发于鼻腔及鼻咽部,其次好发于皮肤,临床表现、病理特征、免疫表型及EBER CISH检测可明确诊断,必要时可行TCR基因重排检测鉴别,该肿瘤预后差,生存时间短。Purpose To investigate the clinicopathological features,treatment and prognosis of extranodal NK/T cell lymphoma(ENKTL),nasal type.Methods The expression of CK(AE1/AE3),EMA,CD20,CD79a,CD3,CD43,CD4,CD8,CD56,TIA-1,perforin,Granzyme B(GrB),Ki-67 in 55 ENKTL nasal type was detected by EnVision two-step immunohistochemistry,and the relevant literatures were reviewed.Results Among 55 patients with ENKTL,36 were males and 19 were females,aged 22-80 years,with a median age of 57 years.The most common sites were nasal cavity and nasopharynx,followed by skin.Immunohistochemical markers CD3 was the most sensitive,CD56,TIA-1,perforin,GrB were positive.Chromogenic in situ hybridization(CISH)showed that 55 cases EBER were positive(100%).Twenty-seven patients were followed up.Eleven of them died(survival time 1-68 months),the median survival time was 15 months.Conclusion The most frequent site of ENKTL is nasal cavity and nasopharynx,followed by skin.Its clinical manifestations,pathological features,immunohistochemistry and EBER in situ hybridization can make a definite diagnosis,and TCR gene rearrangement can be used for identification if necessary.It has poor prognosis and short survival time.

关 键 词：淋巴瘤 NK/T细胞 免疫组织化学 显色原位杂交 

分 类 号：R733.4[医药卫生—肿瘤]