中华皮肤科杂志 ›› 1997, Vol. 30 ›› Issue (6): 365-368.

• 论著 •    下一篇

原发性皮肤T细胞淋巴瘤的T细胞受体基因重排分析

王平1, 邱丙森1, 高红阳2, 单易非2, 许良中3   

  1. 1. 上海医科大学皮肤病学研究所皮肤病理研究室 200040;
    2. 上海医科大学皮肤病学研究所生物物理教研室;
    3. 肿瘤医院病理科
  • 收稿日期:1996-11-22 修回日期:1997-09-01 出版日期:1997-12-15 发布日期:1997-12-15

Analysis of T-cell Receptor Gene Rearrangement in Primary Cutaneous T-cell lymphomas

Wang Pin1, Qiu Bingshen1, Gao Hongyang2   

  1. Department of Dermatology, Nanjing Railway Medical College, Nanjing 210009
  • Received:1996-11-22 Revised:1997-09-01 Online:1997-12-15 Published:1997-12-15

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摘要： 目的:评价Southern印迹分析(SBA)和聚合酶链反应(PCR)检测原发性皮肤T细胞淋巴瘤(PCTCL)T细胞受体(TCR)基因重排(GR)的意义.方法:以PCR扩增TCRγ的结合Ⅴ(可变区)-J(结合区)序列(TCRγPCR)和SBA分析TCRβ链基因(TCRβSBA)检测克隆性GR.结果:蕈样肉芽肿(MF):TCRγPCR和TCRβSBA检测6例ⅡA期和7例ⅡB期皮损标本的GR分别为5例和4例以及6例和5例,外周血分别有4例、2例和5例、3例示GR;而7例ⅠA期和10例ⅠB期的TCRγGR和TCRβGR皮肤组织为4例、1例和7例、1例,外周血为3例、阴性和4例、1例.1例MFⅡA表现为皮病性淋巴结病患者的淋巴结中证实有GR.疑诊MF:11例患者的皮损和外周血标本经TCRγPCR检测5例皮肤和3例外周血见GR.非蕈样肉芽肿、Sézary综合征的PCTCL:PCR和SBA显示TCRGR分别为皮肤组织占9例/10例和6例/8例,外周血占9例/10例和6例/11例.Sézary综合征和淋巴瘤样丘疹病:2例Sézary综合征外周血和其中1例皮肤标本同时见TCRγGR和TCRβGR;2例淋巴瘤样丘疹病的皮肤标本.

关键词: 皮肤T细胞淋巴瘤, T细胞受体基因重排

Abstract: Objects: To evaluate the significance of T-cell receptor(TCR) gene rearrangment(GR) in primary cutaneous T-cell lymphomas(PCTCL) by detection of Southern blot analysis(SBA) and polymerase chain reaction(PCR). Methods: Clonal GR were simultaneously studied by the amplification of junctional V(variable)-J(joining) sequences of the rearranged TCR genes by PCR(TCR PCR) and the analysis of TCR-chain genes by SBA(TCR SBA). Results: In mycosis fungoides(MF), GR of skin specimens by TCR PCR and TCR SBA were detected in 5 and 4 of 6 patients with MFⅡA, 6 and 5 of 7 patients with MFⅡB respectively. Clonal GR were also seen in 4 and 1 of 7 cases, 7 and 1 of 10 cases in MFⅠA and MFⅠB respectively. GR of blood samples by PCR and SBA were present in 4 and 2 of 6 patients with MFⅡA, 5 and 3 of 7 patients with MFⅡB. GR was confirmed by TCR PCR and TCR SBA in one lymph node showing dermatopathic lymphadenopathy of one case with MFⅡA. In 11 patients of clinically suspected MF, GR were present in skin specimens of 5 cases and blood sample of 3 cases by TCR PCR. In non mycosis fungoides and Sézary syndrome PCTCL, GR were found in 9 skin specimens from 10 patients detected by TCR PCR and 6 skin specimens from 8 patients detected by TCR SBA. GR were also seen in 6 blood samples from 11 patients detected by TCR PCR and 9 blood samples from 10 patients by TCR SBA. In Sézary syndrome(SS) and lymphomatoid papulosis (LyP), TCR GR and TCR βGR were detected in skin specimens of two patients with LyP and blood samples of two patients with SS. GR were seen in one skin specimen of one patient with SS and one blood sample of one patient with LyP detected by TCR PCR. Conclusion: TCR PCR is a useful supplement to other methods for the diagnosis of early and suspected MF.

Key words: Cutaneous T-cell lymphoma, T-cell receptor gene rearrangement