泪腺良性淋巴上皮病变免疫组织化学研究

Immunohistochemical research on benign lymphoepithelial lesion of lacrimal gland

目的通过研究9种单克隆抗体在泪腺良性淋巴上皮病变中的表达,探讨其免疫病理本质及发病机制,为临床治疗及预后提供理论依据。方法使用CD4、CD8、CD21、CD34、CD45、CD68、Ig G、Ig G4和增殖细胞核抗原这9种分子的单克隆抗体,应用免疫组织化学染色SP法对25例泪腺良性淋巴上皮病变的石蜡标本进行免疫组织化学染色。结果B淋巴细胞表面抗原(CD21)、T淋巴细胞表面抗原(CD4、CD8和CD45)、黏附分子CD34及Ig G在25例样本中均呈阳性表达,巨噬细胞表面抗原CD68、增殖细胞核抗原和Ig G4这3种分子在25例样本中均有一定比例的阳性表达,表达率分别为12%、8%和80%。结论泪腺良性淋巴上皮病变是一种主要以B淋巴细胞和T淋巴细胞激活为主要病理免疫基础的疾病,绝大多数属于Ig G4相关性疾病的范畴,同时有发生恶变的潜能,临床治疗后的密切随访很有必要。

Objective To investigate the expression of nine monoclonal antibod- ies in benign lymphoepithelial lesion （BLEL） of lacrimal gland, and explore the immu- nopathologlcal essences and mechanisms involved in BLEL of lacrimal gland. Methods Using SP immunohistochemistry analysis, twenty-five cases of BLEL of lacrimal gland were studied by using a panel of nine monoclonal antibodies, including CD4, CDS, CD21, CD34,CD45, CD68, IgG, IgG4 and PCNA. Results Surface antigens of B ceils （CD21）, T cells（ CD4, CD8 and CD45 ）, adhesion molecule （CD34） and immunoglobul- inG （IgG） were all positively stained in all 25 cases,surface antigens of macrophages （CD68） ,proliferative cell nuclear antigen（PCNA） and immunoglobulinG4 （IgG4） were positively stained in different proportion of cases, which were 12% , 8% and 80% , re- spectively. Conclusion BLEL of lacrimal gland is a disease mainly pathologically fea- tured by the activation of both B lymphocytes and T lymphocytes, the vast majority of which is belong to the IgG4-related disease. Due to its potential possibility of malignant transformation, closely follow up is necessary after the clinical treatment.