蕈样肉芽肿T细胞受体γ单克隆性基因重排研究

Detection of T cell receptor gamma gene rearrangements in mycosis fungoides

目的探讨T细胞受体γ（TCR-1）基因重排在蕈样肉芽肿（MF）诊断中的意义，寻找一种较为敏感的基因诊断方法。方法以TCR-γ基因的Vγ8、Vγ9、Vγ10、Vγ11、Jγ1-2为引物，利用PCR-琼脂糖凝胶电泳方法检测共50份标本的基因重排情况，其中30例MF患者的皮损标本33份，淋巴结标本2份；15例炎症性皮肤病患者的15份皮损标本。结果30例MF患者的33份皮肤标本，共有29份检测到TCR-γ基因单克隆陛重排的条带，总阳性率为88％。15份炎症性疾病皮肤标本中，共有5份检测到TCR-γ基因单克隆性重排的条带，阳性率为33％。结论TCR-γ基因重排检测可以应用于MF的诊断与鉴别诊断，但只能作为一种辅助诊断方法。

Objective To assess the diagnostic significance of T cell receptor gamma gene rearrangements in mycosis fungoides （MF）, so as to develop a sensitive diagnosis tool. Methods A total of 50 specimens were collected, including 33 skin lesion specimens and 2 lymph specimens from 30 patients with MF, 15 skin lesion specimens from 15 patients with inflammatory dermatoses. PCR was performed with specific primers targeting TCR V gamma 8, 9, 10, 11 to detect T cell receptor gamma gene rearrangement. Results Monoclonal rearrangements of TCR gene was observed in 88% （29/33） of specimens from patients with MF and 33% （5/15） of samples from patients with inflammatory dermatoses. Conclusions The detection of TCR gene rearrangements, as an ancillary test, is useful in the diagnosis and differential diagnosis of MF.