淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞亚型免疫表型特征分析

Immunophenotypic Characterization of Nodal Follicular Helper T Cell Lymphoma,Angioimmunoblastic⁃type

目的:探究淋巴结滤泡辅助T细胞淋巴瘤-血管免疫母细胞亚型(nTFHL-A)免疫表型特征,探讨流式细胞术在其中的诊断价值。方法:搜集华中科技大学同济医学院附属同济医院血液科2010年1月至2023年8月初诊的nTFHL-A患者227例,回顾性分析初诊nTFHL-A患者的免疫表型特征。结果:胞膜CD3表达减弱或缺失、CD7表达缺失是nTFHL-A筛查时最常见的免疫表型异常,而CD10表达较为特异。几乎所有的患者均强表达PD-1和CD45RO。在部分患者中,由于CD3阳性或表达稍弱而CD7阳性或部分表达(组织11.3%、骨髓10.3%),可能造成流式结果假阴性。通过检测滤泡辅助T细胞标记PD-1有助于提高nTFHL-A检出率,同时有助于与其他外周T细胞淋巴瘤作鉴别。结论:流式细胞术是筛查、确定或鉴别nTFHL-A的重要辅助工具。

Objective:To investigate the immunophenotypic characteristics of nodal follicular helper T⁃cell lymphoma,angioimmunoblastic⁃type(nTFHL⁃A),and to assess the diagnostic value of flow cytometry in nTFHL⁃A.Methods:A total of 227 patients were included in our study.They were initially diagnosed with nTFHL⁃A in the Department of Hematology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,China,from January 2010 to August 2023.Results:The lack and decreased expression of surface CD3 and the CD7 deficiency were the most common immunophenotypeic abnormalities of pan⁃T cell markers in nTFHL⁃A,and CD10 expression was the most specific for nTFHL⁃A.Almost all neoplastic T cells had bright PD⁃1 expression and CD45RO expression.Flow cytometry may present false negative results in patients with CD3⁃positive or slightly decreased expression and meantime with CD7⁃positive or partial expression(tissue 11.3%,bone marrow 10.3%).Bright PD⁃1 expression can improve nTFHL⁃A detection and also help to differentiate it from other peripheral T⁃cell lymphomas.Conclusions:Flow cytometry is an effective tool to screen,identify or differentiate nTFHL⁃A.