Clonal rearrangements of T-cell receptor genes in mycosis fungoides and dermatopathic lymphadenopathy.

Clonal rearrangements of T-cell receptor genes in mycosis fungoides and dermatopathic lymphadenopathy.
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蕈样肉芽肿和皮肤病性淋巴结病中 T 细胞受体基因的克隆重排。

DOI:
10.1056/nejm198508293130903
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发表时间:
1985
期刊:
The New England journal of medicine
影响因子:
--
通讯作者:
Sklar,J
Sklar,J
中科院分区:
--
文献类型:
--
作者:
Weiss,LM;Hu,E;Wood,GS;Moulds,C;Cleary,ML;Warnke,R;Sklar,J

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蕈样真菌病的组织学诊断可能是困难的,特别是在淋巴结表现出经常与慢性皮肤病相关的变化。作为另一种诊断方法,我们分析了14例蕈样真菌病患者活检组织中β t细胞受体基因的DNA结构。这些基因的克隆重排在每个标本中发现,包含组织学上明确的蕈样真菌病。从蕈样真菌病患者身上切除的9个淋巴结中有7个也发现了克隆重排,组织学上认为只有良性淋巴结病。当从相同病例中获得配对标本时,在良性淋巴结和组织学相关组织中检测到匹配的t细胞受体基因重排。我们的研究结果为真菌样霉菌病的克隆t细胞起源提供了分子证据,并表明可触及淋巴结病患者的皮肤外疾病发生率高。此外,本研究表明,重排t细胞受体基因的检测可以成为诊断和表征t细胞肿瘤的一种敏感和实用的方法。(中华医学杂志1985;31:539 - 44)
Histologic diagnosis of mycosis fungoides may be difficult, especially in lymph nodes that show changes frequently associated with chronic skin disease. As an alternative approach to diagnosis, we have analyzed the configuration of DNA for the beta T-cell receptor genes in biopsy tissues from 14 patients with mycosis fungoides. Clonal rearrangements of these genes were found in each specimen that contained histologically unambiguous mycosis fungoides. Clonal rearrangements were also found in seven of nine lymph nodes removed from patients with mycosis fungoides and considered histologically to contain only benign lymphadenopathy. Matching rearrangements of beta T-cell receptor genes were detected in benign lymph nodes and histologically involved tissues when paired specimens were available from the same cases.Our findings provide molecular evidence for the clonal T-cell origin of mycosis fungoides and indicate the high incidence of extracutaneous disease in patients with palpable lymphadenopathy. In addition, this study demonstrates that the detection of rearranged T-cell receptor genes can be a sensitive and practical method for the diagnosis and characterization of T-cell neoplasms. (N Engl J Med 1985; 313:539–44.)
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