流式细胞术结合TCR基因重排在T细胞非霍奇金淋巴瘤诊断中的应用

Utilization of combined flow cytometry and clonal TCR gene rearrangements in the diagnosis of T-cell lymphoma

目的:探讨流式细胞术(FCM)结合PCR技术检测TCR基因重排在T细胞非霍奇金淋巴瘤(TNHL)诊断中的作用。方法:对经组织学确诊的32例T-NHL的组织学形态、免疫组化、FCM免疫表型、细针穿刺细胞学形态及TCR基因重排情况进行回顾性分析。对照组为18例反应性增生和1例坏死性淋巴结炎。结果:组织学诊断的32例T-NHL及19例对照组中,经FCM/TCR基因重排确诊的分别有23例和17例。FCM/TCR基因重排诊断与组织学诊断比较,敏感性为71.9%,特异性为89.5%,准确率为78.4%。结论:FCM免疫表型结合TCR基因重排可作为诊断T-NHL的重要辅助手段之一,尤其对于不能取活检的,需行细针穿刺诊断的患者有较大应用价值。

Objective To study the usefulness of combined flow cytometry （FCM） and polymerasechainreaction examination for clonal TCR gene rearrangements in the diagnosis of T-cell lymphoma （T-NHL）.Methods Histopathologic features, immunohistochemistry, flow cytometric immunophenotyping, cytomorphologicevaluation and TCR gene rearrangements of 32 T-NHL were reviewed retrospectively. The control cases were 18reactive lesions and 1 histiocytic necrotizing lymphaderitis. Results Out of 32 T-NHL, 23 were diagnosed as T-NHLby FCM/TCR gene rearrangements. Of 19 control group, 17 were diagnosed as reactive lesions by FCM/TCRgene rearrangements. The sensitivity, specificity and accuracy were 71.9%, 89.5% and 78.4%, respectively.Conclusions FCM/TCR gene rearrangement is a very important technique in diagnosing T-NHL. Thus, patientswith fine needle aspiration cytology can be saved from having an invasive surgery.