成熟T细胞肿瘤与T细胞反应性增生抗原表达对比研究

Comparison of antigen expression of mature T cell neoplasm and reactive T cell hyperplasia

目的比较成熟T细胞肿瘤与T细胞反应性增生白细胞共同抗原CD45、全T细胞抗原CD2、CD3、CD5、CD7及CD4、CD8等的表达差异,探讨上述抗原表达变化在成熟T细胞肿瘤诊断中的价值。方法对36例成熟T细胞肿瘤及36例T细胞反应性增生流式细胞免疫分型资料进行回顾性分析。根据抗原表达及其与正常T细胞的比较,将T细胞抗原表达模式分为抗原丢失及抗原强度变化。强度变化包括表达减弱、表达增强、双峰表达、表达不均匀等。结果 63.9%的成熟T细胞肿瘤有1项或多项全T细胞抗原丢失(23/36),明显高于对照组的8.3%(3/36),两者差异具有显著性(χ2=21.772,P<0.0001)。36.1%的成熟T细胞肿瘤病例有3项或4项全T抗原强度变化(13/36),明显高于对照组的8.3%(3/36)。两者差异具有显著性(χ2=6.525,P=0.0106)。97.2%的成熟T细胞肿瘤CD4/CD8比例异常(35/36),明显高于对照组的22.2%(8/36),两者差异具有显著性(χ2=39.024,P<0.0001)。27.8%的成熟T细胞肿瘤CD45表达异常(10/36),明显高于对照组的2.8%(1/36),两者差异具有显著性(χ2=6.859,P<0.0088)。结论成熟T细胞肿瘤与T细胞反应性增生在全T细胞抗原、CD4、CD8及CD45表达方面具有明显不同的特点,上述抗体的检测有助于成熟T细胞肿瘤的诊断及鉴别诊断。

Objective To explore the value of detection of leucocyte common antigen CD45,pan-T cell antigen CD2,CD3,CD5,CD7 and T cell subsets antigen CD4 and CD8 in the diagnosis of mature T cell neoplasm by comparing the expression profiles of above antigens in mature T cell neoplasm and reactive T cell hyperplasia.Methods Thirty six cases of mature T-cell neoplasm and 36 reactive T cell hyperplasia with multiparameter flow immunophenotye were retrospectively analyzed.The expression patterns of antigens were classified as loss of antigen,and abnormal intensity of antigen expression including down regulation,up regulation,bimodal and heterogeneity.Results 63.9% of mature T cell neoplasm lost one or more pan-T antigens（23/36）,while only 8.3% cases of control group lost one pan-T antigen（3/36）.The difference was statistically significant（χ2=21.772,P0.0001）.The percentage of mature T cell neoplasm showing 3 or 4 abnormal intensity of pan-T antigens was up to 36.1%（16/36）,which was significantly higher than that of control cases（8.3%,3/36;χ2=6.525,P=0.0106）.Abnormal CD4/CD8 ratio was detected in 97.2% of mature T cell neoplasm showing（35/36）,however only 22.2% of control cases showing abnormal CD4/CD8 ratio（3/36）（χ2=39.024,P0.0001）.The percentage of mature T cell neoplasm showing abnormal expression of CD45 was significantly higher than that of control group（27.8% vs.2.8%;χ2=6.859,P0.0088）.Conclusions Mature T cell neoplasm is different from reactive T cell hyperplasia in expression of pan-T antigen,CD4,CD8 and CD45.Detection of above antigen expression is helpful in the diagnosis of mature T cell neoplasm.