Kikuchi病中检测出全T细胞相关抗原丢失

Loss of pan-T cell antigens CD2, CD3, CD5 and CD7 in Kikuchi＇s disease

目的 观察全T细胞相关抗原CD2、CD3、CD5、CD7在Kikuchi病中是否存在丢失,探讨将全T细胞相关抗原丢失作为鉴别T细胞良、恶性病变辅助诊断依据的局限性.方法 收集33例明确诊断为Kikuchi病和15例淋巴组织反应性增生病例,通过复习HE切片并应用免疫组织化学EliVision法检测病变中CD2、CD3、CD5、CD7的表达情况.结果 72.7％ （24/33）的Kikuchi病患者中存在一种或几种全T细胞相关抗原的丢失,其中13例仅CD5丢失,1例仅CD7丢失,1例仅CD2丢失,2例CD2和CD7丢失,4例CD5和CD7丢失,2例CD2和CD5丢失,1例CD2、CD5和CD7丢失.以CD5丢失最多见（60.6％,20/33）,其次为CD7（24.2％,8/33）和CD2（ 18.2％,6/33）.抗原的丢失多见于增生型及坏死型.经随访,抗原的丢失与Kikuchi病的预后无明显相关性.15例淋巴组织反应性增生病例中无明显抗原丢失现象.结论 Kikuchi病中存在一种或几种全T细胞相关抗原的丢失.因此,将全T细胞相关抗原丢失作为T细胞淋巴瘤辅助诊断依据不适用于Kikuchi病.

Objective To study the possible loss of pan-T cell antigens CD2,CD3,CD5 and CD7 in Kikuchi’s disease and to evaluate the role of T cell antigen loss in distinguishing benign from malignant T-cell lymphoid lesions.Methods Formalin-fixed and paraffin-embedded tissues of 33 cases of Kikuchi’s disease and 15 cases of reactive lymphoid hyperplasia were studied by EliVision immunohistochemical staining for CD2,CD3,CD5 and CD7.Results Twenty-four of the 33 （ 72.7% ） cases of Kikuchi’ s disease lost one or more of the pan-T cell antigens,including the loss of CD5 only （ 13 cases）,CD7 only （1 case）,CD2 only （1 case）,CD2 and CD7 （2 cases）,CD5 and CD7 （4 cases）,CD2 and CD5 （2 cases）,and CD2,CD7 and CD5 （ 1 case）.Amongst these cases,the commonest antigen loss was CD5 （20cases,60.6% ）,followed by CD7 （8 cases,24.2% ） and CD2 （6 cases,18.2% ）.Compared with the xanthomatous subtype of Kikuchi’s disease,the loss of antigens was more commonly seen in the proliferative and necrotizing subtypes.Analysis of follow-up data showed that the loss of antigens in Kikuchi’s disease was not significantly associated with the prognosis.In reactive lymphoid hyperplasia,the expression of CD2,CD3,CD5 and CD7 was seen in all cases with similar intensity,with no obvious pan-T cell antigen loss.Conclusion Loss of one or more pan-T cell antigens in Kikuchi’s disease is demonstrated in present study,suggesting that the immunophenotypic pattern is not unique in T cell lymphoma.