The relevance of the CD4+CD26-subset in the identification of circulating Sezary cells
The relevance of the CD4+CD26-subset in the identification of circulating Sezary cells
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DOI：
10.1046/j.1365-2133.2001.04014.x
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发表时间：
2001-01-01
影响因子：
10.3
通讯作者：
Fierro, MT
中科院分区：
文献类型：
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作者：
Bernengo, MG;Novelli, M;Fierro, MT
背景在Sezary综合征(SS)患者中，缺乏循环肿瘤T细胞表型的特异性标志物，这使得确定克隆性细胞的存在和量化外周血中的肿瘤负荷变得困难。目的应用高分辨二、三、四参数流式细胞术，探讨皮肤T细胞淋巴瘤患者外周血淋巴细胞CD26表达与外周血侵犯的关系及其在SS诊断中的意义。方法选择52例SS患者，151例不同临床分期的真菌病(MF)患者(其中14例为血液型)，88例红皮病炎性皮肤病(EISD)患者和72例健康献血员(HD)。结果23例SS、141例MF、71例EISD和72例HD患者的CD26+百分率均高于30%，而HD、EISD和B-0-MF患者的CD26百分率均低于30%。SS组与HD组、EISD组与B-0-MF组CD26-、CD4+CD26-百分率及绝对值差异均有统计学意义。B-1-MF患者CD_(26)、CD_4+CD_(26)百分值(绝对值不明显)显著高于HD、EISD和B-0-MF患者(P<；0.001)。SS组CD_(26)绝对值、CD_4~+CD_(26)百分率及绝对值均显著高于B-1-MF(P<；0.001)。在SS和B-1-MF中，CD_4+CD_(26)百分比值与淋巴组织中循环SC的百分率呈显著正相关(r=0.77，P<0.001)。在循环中的TCRvβ群扩大或T细胞抗原丢失的患者中，表型克隆细胞上CD26的缺失得到证实。分离的SS和HD患者外周血中的CD4+CD26-细胞均具有SC的脑状核团特征。结论我们认为外周血中CD4+CD26-的百分比值高于30%可以准确地判断SS和MF患者外周血中是否存在受累。
Background The lack of specific markers for the phenotyping of circulating neoplastic T cells in Sezary syndrome (SS) patients makes it difficult both to ascertain the presence of clonal cells and to quantify the tumour burden in the peripheral blood. In previous reports we showed that the lack of CD26 (dipeptidyl-aminopeptidase IV) is a characteristic feature of circulating Sezary cells (SC).Objectives The purpose of this study was to ascertain, by means of high-resolution two-, three- or four-parameter flow cytometry, the relationship between CD26 expression on peripheral blood lymphocytes and peripheral blood involvement in cutaneous T-cell lymphoma patients and to assess its significance in SS diagnosis.Methods The patient population included 52 SS patients, 151 mycosis fungoides (MF) patients at different clinical stages (including 14 with blood involvement, B-1-MF), 88 patients with erythrodermic inflammatory skin diseases (EISD) and 72 healthy donors (HD). CD26+ values were available in all cases, whereas CD4+ CD26- level measurement was performed in 23 SS, 141 MF, 71 EISD and 72 HD.Results CD4+ CD26- percentage values were higher than 30% in all but one B-1-MF and higher than 40% in all SS cases, whereas HD, EISD and B-0-MF patient values were always lower than 30%. A statistically significant difference was found in both CD26- and CD4+ CD26- percentage and absolute values between SS and HD, EISD and B-0-MF patients. The CD26- and CD4+ CD26- percentage values (but not the absolute values) were significantly higher in B-1-MF compared with HD, EISD and B-0-MF patients (P < 0.001). Moreover, CD26- absolute values and CD4+ CD26- percentage and absolute values were significantly higher in SS than in B-1-MF (P < 0.001). A statistically significant direct relationship was found between CD4+ CD26- percentage values and the percentage of circulating SC within the lymphoid population in SS and B-1-MF (r = 0.77; P < 0.001). The lack of CD26 was confirmed on phenotypically clonal cells in patients with an expanded circulating TCRv beta population or a T-cell antigen loss. Sorted CD4+ CD26- cells from both SS patients and HD showed the characteristic cerebriform nuclei of SC.Conclusions We feel that a CD4+ CD26- percentage value higher than 30% of peripheral blood lymphocytes could correctly identify the presence of peripheral blood involvement in SS and MF patients.