p53 immunoreactivity is uncommon in primary cutaneous lymphoma

p53 gene mutation appears to play an important role in the development of systemic lymphoma, and may be associated with tumour progression. Its role in cutaneous lymphoma is currently unknown. We examined p53 expression in 55 biopsies of cutaneous lymphoma, including patch-, plaque- and tumour-stage mycosis fungoides (MF), T- and B-cell lymphoma and lymphomatoid papulosis. Strong, homogeneous p53 expression, thought to correlate most closely with p53 gene mutation, was seen in only three cases; in a plaque and tumour from a patiënt with tumour-stage MF, in plaque-stage MF in a patient without tumours, and in one case of CD30⁺ large-cell anaplasüc lymphoma. These data suggest that p53 gene mutation is not a critical step in the development of the majority of primary cutaneous lymphomas.     

T-cell lymphoma of the skin--clinicopathological relationships, therapy and survival

We investigated the pretreatment characteristics and prognosis of T-cell lymphomas, including mycosis fungoides (MF), T-cell lymphoma of the skin other than MF (CTL), adult T-cell leukemia/lymphoma (ATL), immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma and angioimmunoblastic lymphadenopathy with dysproteinemia (AILD), as well as B-cell lymphoma of the skin (CBL) and analyzed the prognostic factors for skin T-cell lymphoma when the skin was the organ initially or predoienantly involved. Twenty-eight cases of erythematous-stage MF, ten cases of plaque-stage MF, eleven cases of tumor-stage MF, twelve cases of ATL, eleven cases of IBL-like T-cell lymphoma/AILD, and eight cases of CBL were studied. CTCL patients were treated by photochemotherapy with topical 8-methoxypsoralen (8-MOP) followed by VUA irradiation, electron-beam irradiation, or systemic chemotherapy. Complete remission (CR) was obtained with all of these therapies. However induction of CR was not a major prognostic factor in skin T-cell lymphoma, and the clinical stage was more valuable in this respect. No cases of death occurred among erythematous-stage MF patients, but eight out of 11 patients with tumor-stage MF died (mean survival rate, 38 months). The prognosis for tumor-stage MF was better than that of ATL (19 months) or IBL-like T cell lymphoma/AILD (28 months), but worse than those of erythematous-a plaque-stage MF. TNM staging of CTCL was also a useful factor for prognosis.     

Expression of Fas and Fas-ligand in primary cutaneous T-cell lymphoma (CTCL): association between lack of Fas expression and aggressive types of CTCL

BACKGROUND: Fas (CD95; APO-1) is a transmembrane protein that mediates apoptosis upon cross-linking with Fas-ligand (Fas-L). Interaction of Fas-L expressed by cytotoxic T cells with Fas-expressing tumour cells plays an important part in antitumour immune responses. OBJECTIVES: We aimed to investigate Fas and Fas-L expression in frozen and paraffin-embedded material from a large group of patients with cutaneous T-cell lymphoma (CTCL). METHODS: Immunostaining with monoclonal antibodies against Fas and Fas-L was performed in material from 23 patients with mycosis fungoides (MF), 10 with lymphomatoid papulosis (LyP), 10 with CD30-positive primary cutaneous large T-cell lymphoma (LTCL) and nine with CD30-negative LTCL. The results were correlated with the type and stage of CTCL and clinical features. RESULTS: Expression of Fas by the large majority of the neoplastic T cells was observed in 15 of 15 cases of plaque-stage MF, 10 of 10 cases of LyP and 10 of 10 cases of CD30-positive LTCL, but only in four of 12 cases of tumour-stage MF and two of nine cases of CD30-negative LTCL. In three of four MF patients in whom both plaques and tumours could be studied, a significant decrease in Fas expression was observed with progression from plaque-stage to tumour-stage disease. Fas-L was expressed by > 50% of the neoplastic T cells in 46 of 56 biopsies, and no clear relationship with type of CTCL and clinical behaviour was observed. CONCLUSIONS: This study demonstrates loss of Fas expression in aggressive types of CTCL, but not in indolent types of CTCL. These data suggest that loss of Fas receptor expression may be one of the mechanisms that allow tumour cells to escape an effective immune response, and may contribute to the unfavourable prognosis of some types of CTCL.     

CD117 immunoreactivity in atypical fibroxanthoma

Atypical fibroxanthoma (AFX) is a spindle cell neoplasm of the skin seen typically on sun-damaged skin of the elderly. Though described as a benign entity, local recurrence and distant metastasis have been reported. This study aims to investigate the potential pathogenic role of CD117, the c-kit receptor in AFX. CD117 was detected in 15 of the 16 cases (94%). The percentage of positive cells for CD117 expression among all tumors was approximately 30%. CD117 proved to be a very sensitive marker of AFX. This antibody may be a useful diagnostic adjunct in AFX.     

Malignant blue nevus with lymph node metastases

Background:  Malignant blue nevi arise within cellular blue nevi and contain atypical mitoses, necrosis, nuclear pleomorphism and prominent nucleoli. Malignant blue nevus has been described as a distinct identity, a rare form of malignant melanoma, and a misdiagnosed melanoma.
Methods:  We present a patient with metastatic malignant blue nevus and studies on the histopathologic, immunohistochemical, and molecular features of the neoplasm.
Results:  Histology showed a malignant blue nevus arising in a combined intradermal and cellular blue nevus. CD117 (c-kit) staining showed diffuse cytoplasmic expression within the cellular blue nevus, decreased staining in the malignant component, and variable positivity within the lymph node metastases. Molecular loss of heterozygosity analysis showed different allelic patterns at the hOGG-1 locus between the melanoma and control skin specimens with a varying heterozygous allelic pattern in both the benign and malignant blue nevus.
Conclusions:  Our case of malignant blue nevus with lymph node metastasis involved mutation of the hOGG-1 DNA repair gene. CD117 showed decreased staining of the primary malignant blue nevus with marked upregulation in the metastatic lesion, unlike most metastatic melanomas. Further study is needed to determine if hOGG-1 mutation or c-kit upregulation play a role in the pathogenesis of dendritic melanocytic lesions (either benign or malignant).     

Comparative analysis of histologicai and immunohistological features in mycosis fungoides and Sézary syndrome

Mycosis fungoides (MF) and Sezary syndrome (SS) are closely related cutaneous T-cell lymphotmas, which differ in several clinical aspects. We compared histological and immunophenotypical features of these two entities, which could be implicated in the dermotropism and epidermotropism, characteristic for both of them. Thirteen biopsy specimens from patients with established plaque-stage MF and 13 from SS patients were examined retrospectively, and 21 histological criteria were assessed. Further, 9 cryosections from MF lesions and 9 from SS lesions were stained for LFA, ICAM1, CD40, CD40-ligand, CD28, CD80, CTLA-4, CD86, FAS, FAS-ligand, CLA and CD 15s. The only histological criteria that showed persistent differences were acanthosis (in 12 of 13 SS and in 7 of 13 MF specimens) and Pautrier collections (detected in 6 SS and 11 MF biopsies). Patterns of staining with the antibodies mentioned above were found to be similar. Our results indicate that these interaction molecules seem to be involved in the pathogenesis of MF and SS, but their immunohistochemical distribution does not contribute to the differentiation between the two entities.     

c-kit Mutation in generalized lentigines associated with gastrointestinal stromal tumor

We describe the case of a 59-year-old Japanese woman presenting with generalized lentigines without systemic anomalies. She had a medical history of gastrointestinal stromal tumors (GISTs), in which gain-of-function mutations of the c-kit gene had recently been found. We detected a point mutation at codon 557 in exon 11 of leukocyte DNA from the patient. The stem cell factor-type III receptor tyrosine kinase pathway plays important roles in the regulation of melanocyte proliferation and differentiation. We speculate that the generalized lentigines of the patient may be caused by melanocyte proliferation due to the c-kit gene mutation.     

斑驳病一家系c-kit基因突变检测及共聚焦激光扫描显微镜皮损观察

目的 报告一例斑驳病家系，运用共聚焦激光扫描显微镜对先证者进行实时在体组织学检查和诊断，并检测该家系患者c-kit基因突变位点。方法 应用Vivascope 1500TM皮肤在体共聚焦成像系统对患者皮损进行扫描成像和诊断。采集患者及表型正常者静脉血，提取其外周血白细胞DNA，PCR扩增c-kit基因编码区21对外显子，DNA直接测序，确定点突变的位点。结果 患者白斑处共聚焦激光扫描成像结果显示基底层几乎无黑素细胞分布，白斑与色素斑交杂区扫描显示基底层及真皮乳头周围黑素细胞呈灶性或区域性聚集。家系中患者 c-kit基因均于17号外显子的2362 位碱基发生T > C突变，密码子TGT突变为CGT，导致高度保守区的Cys 788 Arg （C788R）错义突变。表型正常者及100例正常人对照未见此突变。结论 皮肤在体共聚焦激光扫描显微镜具有实时、无创的特点，在斑驳病等色素缺失性疾病中可作为传统组织病理之外可供选择的新型诊断手段。Cys 788 Arg突变可能为此家系斑驳病的主要原因。     

Solitary skin lesions with histopathologic features of early mycosis fungoides

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma that usually begins with cutaneous patches that evolve into plaques and tumors. A few recent reports describe a solitary variant of MF distinct from localized pagetoid reticulosis, a disease in which solitary verrucous lesions occur on acral skin. Solitary skin lesions with some of the histopathologic features of MF rarely occur during treatment with several drugs, especially antidepressants or antihistamines. We analyzed the clinicopathologic features of 20 patients with solitary skin lesions showing histopathologic features of patch- or early plaque-stage MF. Eight men and 12 women (mean age 50.6, range 23-82, median 49) had solitary, small erythematous patches or plaques located on the trunk (16 cases, 6 of them on the breast), upper extremities (3 cases), and inguinal region (1 case). Ten patients were treated with one or more drugs; only two of them received antidepressants or antihistamines. Histopathologic examination revealed in all cases a band-like infiltrate in the upper dermis, frequently with epidermotropism of solitary lymphocytes. Atypical lymphocytes were present in a minority of cases. Immunohistology showed a predominance of CD3+ T lymphocytes, in most cases admixed with clusters of CD20+ B-cells. Only a small proportion of the infiltrate was CD8+. Molecular analysis of the rearrangement of the T-cell receptor genes was performed in 16 cases using the polymerase chain reaction (PCR) technique and revealed a monoclonal band in 8 of them. After surgical excision, 2/14 patients had a recurrence near the surgical scar. In 18 patients with complete follow-up data, no evidence of "classic" MF could be observed after a mean follow-up of 31.9 months. Solitary skin lesions with the histopathologic features of MF can be considered as a distinct clinicopathologic entity, probably representing a solitary variant of mycosis fungoides.     

Lack of c-kit mutation in familial urticaria pigmentosa

Somatic mutations within c-kit have been reported in individuals with mastocytoses, including urticaria pigmentosa (UP). We have identified three siblings with UP. We aimed to determine whether the c-kit proto-oncogene was playing a part in the aetiology of UP in these three siblings. Using seven microsatellite repeat markers spanning an 8-cM interval encompassing the c-kit gene we followed the transmission of the c-kit gene in this family. Furthermore, single-strand conformation polymorphism analysis was used to scan exon 17 of the c-kit gene for mutations in genomic DNA of all family members and somatic DNA extracted from skin of the eldest affected sibling, the proband. No mutations were found in exon 17 in either genomic DNA of all family members or somatic DNA of the proband. Patients with UP have been shown to possess somatic mutations of the c-kit gene. However, this locus has been excluded as playing a part in the three siblings examined here in whom a second gene locus must be determining their UP. Therefore, this study emphasizes genetic heterogeneity in UP. Future study to identify primary molecular determinants of UP should include affected sib-pair studies.     

Dendritic cells and apoptosis in mycosis fungoides

BACKGROUND: The existence of an effective antitumour immune response in mycosis fungoides (MF) has been shown by the isolation of tumour-specific T-cell clones from such patients. Dendritic cells (DCs) are considered crucial for the induction of immunity, including resistance to tumours. Apoptotic tumour cells are a major source for tumour antigens processed and presented by DCs via cross-presentation. The production of interleukin (IL)-10 by MF tumour cells is acknowledged and may block DCs maturation leading to tumour tolerance. OBJECTIVES: Cross-presentation of apoptotic tumour cells by DCs will induce immunity if the DCs mature, but tolerance if maturation does not occur. We now further characterize the DCs in skin infiltrates of patch/plaque-stage MF (PS) and tumour-stage MF (TS) in situ. Secondly, we demonstrate apoptosis in MF infiltrates in situ and analyse the association of apoptotic cells to immature DCs, mature DCs and IL-10-positive cells. METHODS: Immunohistochemical staining (single, double, triple) employing novel markers specific for immature and mature DCs, IL-10 and a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling (TUNEL) test were done on representative skin biopsies from PS and TS. RESULTS: In PS, the immature DCs are mostly lag/langerin + Langerhans cells (LCs). In the epidermis of PS, LCs predominate over fully mature DCs (non-LC type, CD83+, DC-lamp+). In the dermis of PS and TS, equal numbers of mature and immature (CD1a+, CD1c+) DCs are densely interspersed between the lymphocytic infiltrate. In TS, immature DCs mostly lack lag or langerin expression. Immature DCs with incorporated apoptotic cells were found rarely in PS but increasingly in TS. By triple staining in situ we could now show that strongly IL-10+ cells frequently surround immature DCs, some of them with incorporated apoptotic cells. CONCLUSIONS; DCs in MF perform a dual role, namely induction and maintenance of antitumour immunity, or, under less favourable circumstances such as production of IL-10 downregulation of antitumour immunity. The latter condition was mainly seen in TS, possibly explaining disease progression. Further in vitro studies are now required illuminating the role of DCs for the antitumour immune response in MF.     

蕈样肉芽肿皮损中IL-10与树突状细胞关系的研究

目的探讨蕈样肉芽肿(MF)疾病进程中IL-10的变化特征与树突状细胞(DC)的关系。方法取皮肤MF肿瘤组织冰冻切片,采用单克隆抗体免疫组化染色(AEC,DAB,VIP单染,DAB/VIP双染及DAB/VIP/H istoG reen多染)及TdT介导的dUTP缺口末端标记技术(TUNEL)进行原位检测。结果MF肿瘤组织的斑片及斑块期真表皮内IL-10+细胞数明显低于肿瘤期(P<0.05),肿瘤期真皮浸润性T细胞区域可见许多IL-10+细胞,为两种不同的细胞。双染显示IL-10+细胞常聚集在未成熟的DC周围,多染发现吞噬有凋亡细胞的未成熟DC周围有IL-10+细胞存在。结论MF皮损中IL-10增多是这一疾病进展的重要征象,它可能至少有两种细胞分泌,在肿瘤期,IL-10可能通过阻止吞噬有凋亡细胞的DC的成熟诱导抗肿瘤免疫耐受。     

UV-B-induced bullous pemphigoid restricted to mycosis fungoides plaques

We describe a 77-year-old female patient with plaque-stage mycosis fungoides (MF) who developed bullous lesions in lesional skin only, while receiving short-wave ultraviolet radiation (UV-B) therapy. Histopathological and immunohistochemical examination resulted in a diagnosis of bullous pemphigoid (BP). Withdrawal of the UV-B treatment and application of a high-potency topical corticosteroid cream resulted in a rapid regression of the BP. As the bullous lesions were strictly confined to the MF plaques, the cutaneous infiltrate was probably involved also in the development of the BP. To our knowledge, this is the second case report of the coexistence of MF and BP and the first one in which the BP might be UV-B-induced.     

CD44 variant expression in cutaneous T-cell lymphoma

Expression of the lymphocyte homing receptor CD44 and its splice variants have been linked to tumour dissemination and poor prognosis in non-Hodgkin's lymphoma. Specifically, the in vitro expression of variant exon V6 confers metastatic potential in rat pancreatic carcinoma cell lines. In this study, we investigated the expression of CD44 splice variants in cutaneous T-cell lymphomas, including patients with mycosis fungoides (MF), Sezary syndrome (SS), large-cell anaplastic lymphoma (LCAL) and HTLV1-associated cutaneous lymphoma. In addition, 4 involved lymph nodes from 2 patients with MF and 1 patient with SS were examined. Inflammatory dermatoses, lichen planus and psoriasis, and normal skin were also studied. Immunohistochemistry was performed using a panel of monoclonal antibodies, including those with specificity for CD44H (standard isoform) and variant exons V3, V6 and V8-9. Normal epidermal keratinocytes were consistently CD44H and CD44 V3, V6 and V8-9 positive. In all the different clinicopathological subtypes and stages of cutaneous T-cell lymphomas, including involved lymph nodes, tumour cells consistently expressed CD44H, but were CD44 V3 and V6 negative. CD44 V8-9 was expressed on a majority of tumour cells in 2/5 LCAL and on occasional tumour cells in 2/5 LCAL. Occasional V8-9 positive tumour cells were also identified in 6/13 MF, 1/4 SS and 3/4 HTLV1. In 2/3 lymph node samples from 2 patients with tumour-stage MF, CD44 V8-9 expression was found on a small percentage of atypical mono-nuclear cells. Scattered V8-9 positive dermal mononuclear cells were present in sections of lichen planus and psoriasis. We have found no evidence to suggest that the metastasis-associated CD44 variant exon (V6) is expressed in cutaneous T-cell lymphoma, or that CD44H expression is associated with an adverse prognostic group. It is not clear whether the strong expression of CD44 V8-9 in 2 patients with CD30 positive LCAL reflects activation status or metastatic potential.     

蕈样肉芽肿与扁平苔藓、银屑病浸润细胞的免疫组化比较

目的 探讨免疫表型对蕈样肉芽肿与扁平苔藓、银屑病鉴别诊断的意义.方法 应用ABC免疫组化技术检测15例蕈样肉芽肿,17例银屑病和17例扁平苔藓,6例正常人皮肤的CD1a、CD4、CD8、ICAM-1、LFA-1、HLA-DR(树枝状细胞)、CD30和CD7的表达情况.结果 蕈样肉芽肿表皮CD1a,CD30,ICAM-1(单一核细胞P<0.001,树枝状细胞P<0.01)的阳性细胞密度明显高于扁平苔藓、银屑病、正常人皮肤.蕈样肉芽肿表皮CD4,CD8,HLA-DR的阳性细胞密度明显高于扁平苔藓.蕈样肉芽肿真皮中CD1a阳性细胞的线性密度(P<0.01),真皮内ICAM-1和LFA-1阳性细胞百分比亦较扁平苔藓增多(P<0.05).蕈样肉芽肿表皮CD7阳性细胞与扁平苔藓、银屑病比较差异无统计学意义.银屑病和扁平苔鲜真皮内CD7阳性细胞百分比高于蕈样肉芽肿和正常人皮肤.结论 蕈样肉芽肿和扁平苔藓、银屑病皮损CD1a、CD4、CD8、ICAM-1、LFA-1、HLA-DR、CD30和CD7免疫表型有差异,其结果可为探讨发病机制提供线索.     

Immunohistochemical staining for CD45R isoforms in paraffin sections to diagnose mycosis fungoides-type cutaneous T-cell lymphoma

The definitive diagnosis of mycosis fungoides (MF)-type cutaneous T-cell lymphoma (CTCL) is difficult because a cumulative set of information is typically required: clinical features, histopathology, and special diagnostic tests (typically immunophenotyping and T-cell receptor gamma [TCRgamma] gene rearrangement). Fresh tissue is not always available for the special tests. We report a simple and readily available procedure evaluating the staining pattern on formalin-fixed, paraffin-embedded skin that can help with the diagnosis of patch/plaque stage MF. We reviewed 92 cases of MF or probable MF that had clinical information, immunophenotyping and TCRgamma gene rearrangement studies and that had been evaluated in our multidisciplinary lymphoma conference. We used antibodies to the isoforms of CD45, CD45RO for mature T cells and CD45RB for subsets of T cells. When atypical CD45RB-positive/CD45RO-negative cells were seen in nonspongiotic epidermis, the individuals had a high cumulative clinical and histologic score for MF. In contrast, 15 cases of known contact dermatitis showed a reactive pattern of both CD45RB- and CD45RO-positive cells in spongiotic epidermis. We compared the epidermal CD45RB-positive/CD45RO-negative staining pattern with CD7 deficiency by immunophenotyping and TCRgamma gene rearrangement, two commonly used methods in the diagnosis of MF. The epidermal CD45RB-positive/CD45RO-negative staining pattern is comparable and may be better in equivocal cases of possible MF. Therefore immunostaining for CD45RB and CD45RO on paraffin sections is a simple, reliable, and convenient modality in the diagnosis of MF.     

Cutaneous involvement by colonic extranodal NK/T-cell lymphoma mimicking mycosis fungoides: a case report*

We report a 51-year-old woman with cutaneous involvement by extranodal NK/T-cell lymphoma (TCL) of the colon that microscopically mimicked mycosis fungoides (MF). She had a history of fever of unknown origin for 2 months and then developed multiple erythematous papules on her trunk and extremities. A skin biopsy revealed superficial infiltration by atypical small to medium-sized lymphocytes with epidermotropism and Pautrier collections. Immunohistochemical studies showed expression of CD3 and TIA-1 with lack of expression (double negative) of CD4 and CD8. Initially, we reported the diagnosis as MF, cytotoxic variant. Thereafter, computerized tomography scan incidentally identified a colonic mass. A colonic biopsy revealed infiltration of atypical lymphoid cells with the same morphology and immunophenotype as those found in the skin. Additionally, CD56 and Epstein-Barr virus-encoded RNA in situ hybridization in both skin and colonic biopsies were diffusely positive. Thus, extranodal NK/TCL was diagnosed. Delta T-cell receptor (TCR) gene rearrangement was documented in the skin biopsy by polyacrylamide gel electrophoresis and fluorescence capillary gel electrophoresis methods. There was no TCR gene rearrangement detected in the colonic biopsy. Unfortunately, the patient died within 2 months of diagnosis.     

Mycosis fungoides with a CD56+ immunophenotype

We report 3 cases of mycosis fungoides (MF) with a CD56+ cytotoxic immunophenotype. Each patient presented with a different clinical phenotype: one exhibited limited poikilodermatous patches (skin stage T1); one, widespread hypopigmented lesions (skin stage T2); and one, poikiloderma with a single cutaneous tumor (skin stage T3). MF was confirmed both histologically and by the presence of a T-cell receptor clone in lesional skin in all cases. CD56 and T-cell intracellular antigen-1 were expressed by the malignant lymphocytes in all patients and two expressed CD8. No sample demonstrated loss of the pan T-cell markers CD2 or CD3. None of the 3 developed systemic disease and T-cell receptor gene analysis of peripheral blood was polyclonal in all cases. Only 3 cases of CD56+ MF have been reported previously, none of which exhibited tumor-stage disease. Currently, the disease in our patients appears to be behaving in a manner similar to that predicted for MF with a normal immunophenotype but the prognosis has to be guarded in view of the rarity of this subtype.     

The possible interaction between periostin expressed by cancer stroma and tumor‐associated macrophages in developing mycosis fungoides

Mycosis fungoides (MF) starts as an indolent disease, progresses from a patch stage to confluent plaques and ultimately develops skin tumors. Tumor‐associated macrophages (TAMs) play roles in maintaining the tumor microenvironment in MF. The purpose of this study was to elucidate the involvement of TAMs in the lesional skin of different stages of MF. First, we immunohistologically examined the percentage of CD163⁺ macrophages and CD206⁺ cells, as well as the levels of periostin and IL‐4 in cancer stroma. The percentage of CD206⁺ cells increased in parallel with tumor progression, while there was no significant difference in the percentage of CD163⁺ cells. Periostin was prominent in the stromal area at the patch and plaque stages but decreased at the tumor stage. In contrast, IL‐4 was prominently stained at both plaque and tumor stages. To further elucidate the molecular mechanisms of the effects of these stromal factors on TAMs, we examined their effects on mRNA expression in monocyte‐derived macrophages in vitro. Based on microarray analysis and gene ontology, we examined a series of chemokines and MMPs whose expression was strongly connected with periostin stimulation. The DNA microarray results were verified in M2 macrophages using real‐time PCR. We further examined the mRNA expression of these chemokines and MMPs in the presence of periostin and IL‐4 to simulate the advanced stages of MF and validated their protein expression by ELISA. Our present report suggests possible roles of periostin on TAMs in establishing the tumor microenvironment in MF.     

非肿瘤期和肿瘤期蕈样肉芽肿皮损中CXCR3和CD1a的表达

目的 探讨不同分期蕈样肉芽肿皮损中表皮内CXC趋化因子受体3(CXCR3)和CD1a的表达情况.方法 免疫组化法分别检测16例正常人对照、16例非肿瘤期和8例肿瘤期蕈样肉芽肿患者皮损表皮内CXCR3和CD1a的表达情况.结果 当蕈样肉芽肿由斑片/斑块期进展至肿瘤期,表皮内淋巴细胞的CXCR3阳性率由38.9%降至17.5%,两者差异有统计学意义.CD1a在正常对照、非肿瘤期蕈样肉芽肿、肿瘤期蕈样肉芽肿表皮内每高倍视野分别含朗格汉斯细胞7.3、10.6、6.7个.非肿瘤期蕈样肉芽肿表皮内朗格汉斯细胞数量明显多于肿瘤期与正常人对照,肿瘤期与正常人对照差异无统计学意义.结论 蕈样肉芽肿中亲表皮现象与Th1相关趋化因子受体CXCR3及表皮内朗格汉斯细胞数量有关.

Abstract：

Objective To investigate the expressions of CXC chemokine receptor 3 (CXCR3) and CD1a in skin lesions of different stages of mycosis fungoides (MF). Methods The expression and distribution profiles of CD1a and CXCR3 were detected by immunohistochemistry in the epidermis of skin samples from 16 normal human controls, 16 patients with non-tumor (patch/plaque) stage MF and 8 patients with tumor stage MF. Results With the progression of MF from patch/plaque stage to tumor stage, the positivity rate of CXCR3 in intraepithelial neoplastic cells in lesions dropped from 38.9% to 17.5% (P ＜ 0.05). The average number of intraepithelial Langerhans cells (LCs) per high power field (HPF) in skin samples was 10.6 in patch/plaque stage MF, significantly higher than that in normal control (7.3) and tumor stage MF (6.7), while no significant difference was found between normal control and tumor stage MF specimens. Conclusion The epidermotropism in MF may be associated with the expression of T-helper (Th) 1-associated chemokine receptor (CXCR3) and quantity of intraepithelial LCs.