免疫组织化学检测CD3d、CD4、LCK、IL-7R在泪腺良性淋巴上皮病变组织的表达及临床意义

Using the immunohistochemical exam to analyse the expression and clinical significance of CD3d,CD4,LCK and IL-7R in lacrimal benign lymphoepithelial lesion

目的检测LGBLEL患者病变泪腺标本组织中CD3d、CD4、LCK、IL-7R的表达情况,探讨病变组织中CD3d、CD4、LCK、IL-7R的表达与LGBLEL发病之间的关系。方法采用免疫组织化学方法检测LGBLEL患者病变泪腺组织中CD3d、CD4、LCK、IL-7R等蛋白的表达情况,并以单纯眼眶海绵状血管瘤患者瘤体组织标本做对照。采用半定量积分法(semi-quantitative immunoreactivity scores,IRS)计算实验组及对照组标本组织中的阳性表达积分值。结果免疫组织化学检测结果显示LGBLEL组CD3d、CD4、LCK、IL-7R蛋白表达均呈阳性;CD3d在淋巴滤泡周围阳性表达率高达85.5%,在淋巴滤泡间区阳性表达率高达51.8%,总体积分值为强阳性(++++);CD4在淋巴滤泡周围阳性表达率高平均约54.6%,在淋巴滤泡间区阳性表达率高达22.5%,总体积分值为阳性(+++);LCK在淋巴滤泡周围阳性表达率高平均约28.9%,在淋巴滤泡间区阳性表达率高达9.8%,总体积分值为阳性(++);IL-7R在淋巴滤泡周围阳性表达率高平均约9.7%,在淋巴滤泡间区阳性表达率平均约4.6%,总体积分值为阳性(+);CD3d、CD4、LCK、IL-7R在腺上皮腺泡的表达呈现明显差异,其中CD3d阳性表达率最高,表达约13.5%,并可见CD3d阳性细胞侵入腺泡现象,CD4阳性表达率次之,表达约4.5%,偶见侵入腺泡现象。LCK、IL-7R在腺泡的表达均呈阴性,未见侵入腺泡现象。眼眶海绵状血管瘤组CD3d、CD4、LCK、IL-7R表达均呈阴性。结论 CD3d、CD4、LCK、IL-7R因子在LGBLEL病变组织中的表达异常,CD3d、CD4、LCK、IL-7R因子参与了LGBLEL的发病过程。

Objective Detecting the expression of CD3d,CD4,LCK,IL-7R in lacrimal gland benign lymphoepithelial lesion and discussing whether it is related to the pathogenesis of lacrimal gland benign lymphoepithelial lesion.Methods Using the immunohistochemical exam to detect the expression of CD3d,CD4,LCK,IL-7R in lacrimal gland benign lymphoepithelial lesion and orbital cavernous hemangioma was considered as control group.The integral value of positive expression in the experimental group and the control group was calculated by semi quantitative immunoreactivity scores.Results The expression of CD3d,CD4,LCK,IL-7R were elevated in LGBLEL.The positive rate of CD3d expression in the lymphoid follicle is as high as 85.5%,in the interfollicular zones the positive expression rate is 51.8%,the overall score is strongly positive（＋ ＋ ＋ ＋）.The positive rate of CD4 expression in the lymphoid follicle is about 54.6%,in the interfollicular zones the positive expression rate is 22.5%,the overall score is positive（＋ ＋ ＋）.The positive rate of LCK expression in the lymphoid follicle is about 28.9%,in the interfollicular zones the positive expression rate is 9.8%,the overall score is positive（＋ ＋）.The positive rate of IL-7R expression in the lymphoid follicle is about 9.7%,in the interfollicular zones the positive expression rate is 4.6%,the overall score is positive（＋）.The expression of CD3d,CD4,LCK,IL-7R have showed the significant differences in the expression of glandular epithelial acinus,the positive expression of CD3d is the highest,the expression rate is about 13.5%,and you can see the CD3d positive cells invade the acinar.The positive expression of CD4 is about 4.5%,and you can see the CD4 positive cells occasionally invaded acini.The expressions of LCK and IL-7R are negative in acini,there is no invasion of acini.The expression of CD3d,CD4,LCK,IL-7R were normal in orbital cavernous hemangioma.Conclusion The increased expression of CD3d,CD4,LCK,IL-7R in lacrimal gland benign lymphoepithelial lesion may participate in the pathogenesis of lacrimal gland benign lymphoepithelial lesion.