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①目的 通过对血管免疫母细胞性淋巴结病 (AIL)较系统的研究 ,进一步认识AIL的病变性质 ,探讨其可能的发病机制和病因 ,筛选对判定AIL病变性质有临床实用价值的方法和指标。②方法 在临床病理研究的基础上 ,采用PCR技术、免疫组化技术、图像分析技术 ,对 4 4例符合AIL组织学诊断标准病例的免疫表型、基因重排、bcl 2 /IgH融合基因、EBV DNA、DNA含量、P5 3蛋白、bcl 2、c myc、EB病毒潜伏膜蛋白 (LMP 1 )、PCNA等多项指标进行检测分析 ;同时选择非何杰金淋巴瘤 (NHL) 2 0例和淋巴结反应性增生 1 0例作为对照。③结果4 4例AIL的临床表现十分复杂 ,呈多系统、多脏器受累的复杂的临床表现 ;有在某季节 (春季 )集中发病的倾向。AIL的免疫表型表现为以T细胞增生为主。在组织学上 ,AIL表现为良恶性增生兼有的特征 ,片巢状透明细胞增生的出现是诊断恶性的组织学特征。 4 4例AIL中有 1 6例 (36 .7% )为克隆性基因重排阳性 ,其中 1 2例为TCRγ克隆性重排 ,2例为IgH克隆性重排 ,2例为TCRγ和IgH双重排 ,其克隆性重排的检出率在AIL、NHL和反应性增生间的差异均有显著意义 (χ2 =8.2 1 8～ 2 6 .0 36 ,P <0 .0 1 )。 4 4例AILP5 3蛋白阳性表达率为 31 .8% ,2 0例NHLP5 3蛋白阳性表达率为 70 .0 % ,反应性增生者无?
Objective To further understand the pathological features of AIL and to explore the possible pathogenesis and etiology of AIL, and to screen the methods and indexes that have clinical practical value in judging the nature of AIL lesion through the systematic study of angioimmunoblastic lymphadenopathy (AIL). Methods On the basis of clinical and pathological studies, immunophenotypes, gene rearrangements, bcl 2 / IgH fusion genes in 44 cases of AIL histological diagnostic criteria were analyzed by PCR, immunohistochemistry and image analysis. EBV DNA, DNA content, P5 3 protein, bcl 2, c myc, Epstein-Barr virus latent membrane protein (LMP 1), PCNA and other indicators were detected and analyzed; 20 non-Hodgkin’s lymphoma (NHL) Reactive lymph node hyperplasia 10 cases as a control. Results 4 4 cases of AIL clinical manifestations is very complex, multi-system, multiple organ involvement complicated clinical manifestations; have a season (spring) tend to focus on the incidence. AIL immunophenotype showed T cell proliferation. Histologically, AIL is characterized by both benign and malignant hyperplasia, and the appearance of nevus transparent cell hyperplasia is a histological feature for the diagnosis of malignancy. Sixteen (36.7%) of 4 4 AILs were positive for clonal gene rearrangements, of which 12 were TCRγ clonal rearrangements, 2 were IgH clonal rearrangements, and 2 were TCRγ and IgH dual The detection rate of clonal rearrangements was significantly different between AIL, NHL and reactive hyperplasia (χ2 = 8.218 ~ 26.036, P <0.01). 4 4 cases of AILP5 3 protein positive expression rate was 31.8%, 20 cases of NHLP5 3 protein positive expression rate of 70.0%, reactive hyperplasia without?