摘要
目的 筛选高效、方便、经济的对NK/T细胞淋巴瘤更进一步分类与诊断的检测方法。方法 收集了诊断为NK/T细胞淋巴瘤的 34例患者石腊包埋标本 ,2 7例发生于结外 ,7例发生在淋巴结。用多种抗体研究其免疫表型。EB病毒EBER探针原位杂交方法检测病毒感染。PCR方法检测T细胞受体β和γ基因的克隆性重排。 结果 在 34例结外淋巴瘤患者中 ,18例CD56阳性 ,16例TIA 1阳性。2例皮肤淋巴瘤患者中所有的瘤细胞Ki 6 7均阳性。在EB病毒RNA检测中 ,12例发生于上呼吸消化道的病例阳性 ,包括鼻部的 9例 ,以及鼻外的 3例。同样在 2例胃肠道淋巴瘤及 1例皮肤淋巴瘤患者中检测到EBER。 2 2例上呼吸消化道淋巴瘤患者中有 2例检测到了TCRβ或γ基因克隆性重排 ,所有胃肠道和皮肤淋巴瘤患者均检测到了TCR基因重排。 2例其他部位结外淋巴瘤及 7例结内淋巴瘤患者中有 5例显示TCR基因的克隆性重排。结论 大多数上呼吸消化道NK/T细胞淋巴瘤起源于NK细胞 ,只有一小部分为T细胞来源。然而 ,在皮肤及胃肠道中 ,NK样T细胞肿瘤更多见。在淋巴结中 ,NK细胞淋巴瘤很少。由于NK及NK样T细胞淋巴瘤的组织学改变相似 ,在进行NK细胞标志物、细胞毒性颗粒蛋白检测的同时必须检测TCR基因重排才会得到准确诊断。TCR的基因重排检测仍是鉴别NK和NK?
Objective To study the NK/T-cell lymphoma, search for a more efficacious and simpler method and establish a standard guideline for distinguishing the NK-like T-cell lymphoma from the NK-cell lymphoma. Methods Thirty-four NK or T-cell lymphomas from the upper aerodigestive tract (n=22), skin (n=2), gastrointestinal(GI) tract (n=2), lymph nodes (n=7), and other sites (n=1) were studied. Immunophenotype was analyzed by immunohistochemistry. In situ hybridization with EBER 1/2 RNA probes was performed. T-cell receptor (TCR)-β and -γ gene rearrangement was analyzed by polymerase chain reaction(PCR). Results Eighteen cases were positive for CD 56 and 16 for TIA-1 in 34 lymphomas cases. All tumor cells in the skin cases were positive for Ki-67. Epstein-Barr virus (EBV) mRNA was detected in 12 upper aerodigestive tumors including 9 of 12 nasal and 3 extranasal tumors. EBER was also detected in 1 of 2 skin lymphomas and both of the 2 GI lymphomas. Clonal TCR-β and -γ gene rearrangement was detected in 2 of 22 upper aerodigestive, all of the skin and GI lymphomas, and 6 of 9 nodal and other site lymphomas. Conclusion Most upper aerodigestive NK/T-cell lymphomas are genotypically NK derivation, and a few belong to T lineage. However, NK-like T-cell lymphomas more frequently seen in skin and GI tract. Nodal NK-cell lymphoma are quite rare. These two kinds of lymphomas can only be diagnosed with additional immunohistochemical markers, EBER detection by ISH, TCR gene rearrangement or NK-cell receptors (NKRs) RNA detection. Detection of TCR rearrangement remains the important standard for the diagnosis of T-cell lymphoma.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2003年第10期505-509,共5页
Chinese Journal of Hematology