Immunobiological and cell biological study of the pathogenesis of cutaneous lymphomas

90%以上的皮肤淋巴瘤是由T细胞引起的。提示这些T淋巴瘤细胞来源于对皮肤有高亲和力的淋巴细胞。恶性转化的机制尚不清楚。检测淋巴瘤细胞发生单克隆增殖的时间点对于正确诊断、决定治疗和了解复发具有重要意义。我们检测了具有皮肤亲和力的淋巴瘤细胞的原位和体外克隆增殖。过氧化物酶-抗过氧化物酶免疫染色显示蕈样真菌病和Sezary综合征患者CD4^+肿瘤T细胞优先浸润。缺乏通常在T细胞上表达的表面标记物和/或检测到异常表达的抗原是恶性肿瘤的迹象。Southern blott分析显示，皮肤淋巴瘤中T细胞受体基因重排，而免疫表型不能明确肿瘤细胞的谱系，因此表明T淋巴瘤细胞的克隆性增殖。人鳞状癌细胞（DJM-1）无血清培养上清中存在HTLV-1感染T细胞株的趋化因子，提示HTLV-1感染T细胞株的趋表皮性机制。

More than 90% of cutaneous lymphomas are of T cell origin. It is suggested that these T lymphoma cells are derived from lymphocytes with high affinity for the skin. Mechanisms of malignant transformation are still unknown. Detection of the time point in which the monoclonal proliferation of lymphoma cells occurs is important with respect to obtaining the correct diagnosis, deciding the treatment and knowing the recurrence. We examined the in situ and in vitor clonal proliferation of lymphoma cells with the skin affinity.Peroxidase-antiperoxidase immunostaining revealed the preferential infiltration of CD4^+ tumor T cells with a cerebrifrom nucleus in mycosis fungoides and Sezary syndrome. Absence of surface markers usually expressed on T cells and/or detection of abnormally expressed antigens were the indication of malignancy. Southern blott analysis showed rearrangement of T cell receptor genes in cutaneous lymphomas in which immunophenotyping did not specify the lineage of tumor cells, thus indicating clonal proliferation of T lymphoma cells. Chemotactic factors for a HTLV-1 infected T cell line was present in serum-free culture supernatant of a human squamous carcinoma cell line(DJM-1), suggesting the mechanism of epidermotropism.