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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 screen an efficient, convenient and economical method for the further classification and diagnosis of NK / T cell lymphoma. METHODS: Paraffin-embedded specimens from 34 patients diagnosed with NK / T-cell lymphoma were collected, with 27 cases occurring outside the node and 7 in the lymph node. Various antibodies are used to study their immunophenotypes. Epstein-Barr virus EBER probe in situ hybridization for detection of viral infection. Cloning rearrangements of T cell receptor beta and gamma genes were examined by PCR. Results Of the 34 patients with extranodal lymphoma, 18 were positive for CD56 and 16 were positive for TIA1. Ki 2 7 was positive for all tumor cells in 2 patients with cutaneous lymphoma. In the detection of Epstein-Barr virus RNA, 12 cases were positive in the upper respiratory tract, including 9 in the nose and 3 outside the nose. EBER was also detected in 2 patients with gastrointestinal lymphoma and 1 with cutaneous lymphoma. TCR gene rearrangements were detected in 2 out of 2 patients with upper respiratory gastrointestinal lymphoma and in all patients with gastrointestinal and cutaneous lymphoma. Five of the two other patients with extranodal lymphoma and seven with intranodular lymphoma showed a clonal rearrangement of the TCR gene. Conclusion Most of the upper respiratory gastrointestinal NK / T cell lymphoma originated in NK cells, only a small part of T cell sources. However, NK-like T cell tumors are more common in the skin and the gastrointestinal tract. There are few NK cell lymphomas in the lymph nodes. Due to the similar histological changes of NK and NK-like T-cell lymphomas, the detection of NK cell markers and cytotoxic granulins must be accompanied by an examination of the TCR gene rearrangements before they can be accurately diagnosed. TCR gene rearrangement test is still to identify NK and NK?