皮肤假性淋巴瘤免疫组织化学与基因重排的检测

Immunohistochemistry and Gene Rearrangement in Cutaneous Pseudolymphomas

目的:探讨皮肤假性淋巴瘤(CPL)的组织病理、免疫组化及基因重排特点。方法:对28例皮肤假性淋巴瘤(CPL组)和10例扁平苔藓(对照组)患者的石蜡包埋组织采用免疫组化二步法检测皮损中CD3、CD20及CD45RO的表达情况,并应用PCR检测T细胞受体(TCR)-γ和IgH基因重排情况。结果:CPL组真皮浅层内可见大量淋巴细胞浸润,其中以CD3及CD45RO阳性表达为主的共13例,阳性染色主要位于细胞膜,为T细胞CPL;以CD20阳性表达为主的共15例,阳性染色主要定位于细胞膜或细胞浆,为B细胞CPL。TCR-γ基因重排时,CPL组与对照组中出现smear带的分别为8例和3例,差异无统计学意义(P=0.615);IgH基因重排时,CPL组和对照组出现smear带者均为1例,差异无统计学意义(P=0.462)。结论:CPL组织真皮浅层内主要表达CD3、CD45RO的T细胞和表达CD20的B细胞;TCR-γ和IgH基因重排检测在鉴别CPL良恶性方面具有参考意义。

Objective： To study the characteristics of the histopathology, immunohistochemistry and gene rearrangement in cutaneous pseudo lymphomas （CPL）. Methods： Using immunohistochemistry staining method to process the paraffin-embedded tissues of 28 CPL cases（patient group）and 10 lichen planus cases（control group）. The expressions of CD3, CD20 and CD45RO were detected in these tissues by two-step immunohistochemistry method. The gene rearrangement of TCR-γ and IgH was tested by polymerase chain reaction（PCR）. Results： The tissues of patient group reveal plenty of lymphocytic infiltration in the superficial dermis. Thirteen cases of them were mainly positive expression of CD3 and CD45RO. The positive stain was mainly located in cell membrane and proved to be T cell CPL. Fifteen cases were mainly positive expression of CD20, and the positive stain was mainly located in cell membrane or cytoplasm and proved to be B cell CPL. Detection of TCR-γ gene rearrangement showed smear band in 8 cases of CPL group and 3 in control（P=0.615）. For the gene rearrangement of IgH, most of them expressed negative except 1 case appearing smear band in both CPL and control group （P=0.462）. Conclusion： Plenty of lymphocytic infiltration in the superficial dermis is mainly T cell expressing CD3 and CD45RO and B cell expressing CD20. The detection of TCR-γ and IgH gene rearrangement has an important reference value for the diagnosis of malignancy status of CPL.