骨髓增生异常综合征和再生障碍性贫血患者骨髓原始细胞免疫表型分析

目的检测骨髓增生异常综合征（MDS）和再生障碍性贫血（AA）患者骨髓原始细胞免疫表型特征,探讨其对二者发病机制、诊断、分型诊断及鉴别诊断的临床意义。方法选用多种单克隆抗体,应用直接免疫荧光法、流式细胞术和CD45/SSC设门,对MDS组23例、AA组14例、正常对照组9例的骨髓原始细胞各免疫标志的表达率进行检测。结果MDS组与正常对照组相比其造血干/祖细胞抗原CD34、HLA DR、髓系早期抗原CD13、CD33、单核系抗原CD14、T淋巴细胞抗原CD7的表达率增高,髓系成熟抗原CD15、B淋巴系抗原CD19、CD20的表达率降低,DI值增高（P＜0.05）;RAEB组与RA组相比CD34、HLA DR、CD13、CD33、CD14、CD7的表达率增高,CD15、CD3、CD19、CD20的表达率减低,DI值增高（P＜0.05）。AA组与正常对照组相比其CD34、CD13、CD33、CD15的表达率降低,CD3、CD7、CD25、CD22的表达率增高（P＜0.05）。MDS组与AA组相比其CD34、HLA DR、CD13、CD33、CD14的表达率增高,CD3、CD5、CD7、CD15、CD19、CD20、CD22、CD25的表达率显著降低（P＜0.05）。结论MDS和AA患者骨髓细胞免疫表型分析,有助于揭示二者的发病机制,为临床提供新的诊断、分型及鉴别诊断方法。     

甲状腺内胸腺癌1例报告及文献复习

目的：探讨甲状腺内胸腺癌（ITTC）的临床病理学特征、治疗方法和预后,加强临床医生对该病的认识。方法：观察1例ITTC患者的临床表现。肉眼观察肿瘤大体形态表现,行实验室检查和影像学检查,观察甲状腺肿物细针穿刺细胞学表现,光镜下观察肿瘤组织形态表现,对肿瘤组织行免疫组织化学染色和原位杂交检测,术后3和11个月对患者进行随访,并结合文献进行复习。结果：ITTC患者临床主要表现为甲状腺内质稍硬肿物。细胞学检查显示肿瘤细胞呈三维立体结构,部分细胞可见核仁。组织学检查显示癌细胞呈巢状或岛状分布,并向鳞状细胞分化;其周围纤维组织增生,伴淋巴细胞浸润;伴右颈部淋巴结转移。免疫表型检测,癌细胞表达CD117、CD5和P63等,不表达TdT和TTF-1,EBER-ISH （-）。病理诊断为ITTC伴颈部淋巴结转移。患者在术后3和11个月复查CT均未见复发及转移。结论：ITTC恶性程度低,可复发及转移,联合手术及放疗,患者预后良好。     

免疫分型标记物和CD43在非特指弥漫性大B细胞淋巴瘤中的表达及临床意义

目的 探讨免疫分型标记物和CD43在非特指弥漫性大B细胞淋巴瘤(DLBCL NOS)中的表达及其临床意义.方法 收集120例DLBCL NOS临床病理资料进行分析.采用免疫组化法检测CD10、bcl-6、MUM-1和CD43的表达,根据Hans分型将其分为GCB型和non-GCB型.结果 120例DLBCL,NOS中GCB型和non-GCB型分别为38例和82例,Hans分型与DLBCL NOS预后无关(P＞0.05).120例DLBCL NOS中CD43阳性33例(27.5％),CD43表达与性别、临床分期和免疫分型均无关(P＞0.05),与年龄(P=0.036)和生存状态(P=0.004)有关.结论 DLBCL NOS预后差与CD43阳性表达有关,与Hans分型无关.     

Peripheral leukocyte profile in people with temporal lobe epilepsy reflects the associated proinflammatory state

IntroductionMarkers of low-grade peripheral inflammation have been reported amongst people with epilepsy. The mechanisms underlying this phenomenon are unknown. We attempted to characterize peripheral immune cells and their activation status in people with temporal lobe epilepsy (TLE) and healthy controls.Methods and resultsTwenty people with TLE and 19 controls were recruited, and peripheral blood lymphocyte and monocyte subsets evaluated ex vivo by multi-color flow cytometry. People with TLE had higher expression of HLA-DR, CD69, CTLA-4, CD25, IL-23R, IFN-γ, TNF and IL-17 in CD4⁺ lymphocytes than controls. Granzyme A, CTLA-4, IL-23R and IL-17 expression was also elevated in CD8⁺ T cells from people with TLE. Frequency of HLA-DR in CD19⁺ B cells and regulatory T cells CD4⁺CD25⁺Foxp3⁺ producing IL-10 was higher in TLE when compared with controls. A negative correlation between CD4⁺ expressing co-stimulatory molecules (CD69, CD25 and CTLA-4) with age at onset of seizures was found. The frequency of CD4⁺CD25⁺Foxp3⁺ cells was also positively correlated with age at onset of seizures.ConclusionImmune cells of people with TLE show an activation profile, mainly in effector T cells, in line with the low-grade peripheral inflammation.     

Human NK Cells in Health and Disease: Clinical, Functional, Phenotypic and DNA Genotypic Characteristics

Natural killer (NK) cells are the subject of great current interest because of their possible (in vivo) role in tumour cell surveillance and killing, and because of the potential application of cytokine-modulated NK cells in cancer immunotherapy. In addition, clonal proliferations of NK-associated (NKa) cell populations represent a high proportion of chronic (non-B) lymphoid malignancies and abnormal (both clonal and non-clonal) NKa components are being increasingly reported in association with diverse clinical pictures such as autoimmune disease. This communication extensively reviews what is presently known regarding normal and leukaemic NKa phenotypic diversity, the mechanisms of NK-mediated cytolysis, the role of NK cells in malignancy, and the diagnostic and cellular aspects of malignant NKa proliferations.     

Differential Prognosis Detected by Immunophenotyping in Acute Lymphoblastic Leukemia of Childhood with Poor Prognostic Factors

Immunological phenotypes of leukemlc blasts from 50 childrenwith acute lymphoblastic leukemia (ALL) have been examined witha panel of monoclonal antibodies to evaluate their prognosticsignificance. Thirty-seven of them were common-ALL positivefor CD10 "common-ALL antigen (CALLA)" (NL-1), CD19(B4) and HLA-DR.One was pre-B ALL negative for CALLA and another null-ALL whichexpressed HLA-DR alone. Six of the remaining 11 cases were traditionalT-ALL positive for CD2(9.6), and the other five tentative pre-TALL positive for CD7(Tp40) but negative for CD2. Twenty-oneout of 39 patients with non-T ALL were treated with the standardregimen. The 18 children with non-T ALL having poor prognosticfactors, five with pre-T ALL and six with T-ALL were treatedwith the more intensive regimen. The median follow-up periodwas 36 (range 4 to 74) months. Their disease-free survival probabilitieswere compared. It was found that the disease-free survival ofnon-T ALL patients with poor prognostic factors was comparableto that of the patients without such factors as a result ofthe more intensive chemotherapy. Among the patients with poorprognostic factors, those with pre-T ALL as well as those withT-ALL, which were positive for CD7 antigen, were found to havesignificantly short disease-free survival times (P < 0.03).CD7 antibody is most useful for detecting ALL patients withpoor prognoses.     

Prognostic significance of activation and differentiation antigen expression in B-cell non-Hodgkin's lymphoma

Immunophenotyping shows heterogeneity of expression of activation and differentiation antigens in B-cell non-Hodgkin's lymphoma (NHL). To investigate whether antigen expression correlates with clinical behaviour we have studied the clinical presentation and follow-up of a series of 111 B-cell lymphomas previously phenotyped for a panel of antigens including CD groups 5, 9, 10, 21, 23, 25, 30, 38, 4F2 antigen, and transferrin receptor. CD antigens 5, 10, and 23 were expressed significantly more often by low grade lymphomas whereas CD38, 4F2 antigen, and transferrin receptor were more often expressed by high grade lymphomas. There was a significant correlation with survival and age, stage at presentation, histological grade, and expression of 4F2 antigen and transferrin receptor but not with the other antigens studied. 4F2 antigen and transferrin receptor may identify a poor prognostic group of cases in low grade lymphoma but we conclude that phenotyping B-cell NHL for many of the antigens expressed at various stages of B-cell differentiation and activation does not provide clinically useful information in addition to that obtained from standard histological classifications.     

基底细胞样型乳腺癌的临床病理观察

目的 观察基底细胞样型乳腺癌(BLBC)的临床病理特征.方法 采用ER、PR、HER2、Ki-67、CK5/6、CK14和表皮生长因子受体(EGFR)进行免疫组织化学EnVision法检测458例女性浸润性乳腺癌以筛选BLBC,比较BLBC与其他免疫表型乳腺癌的临床病理特征.对其中228例浸润性乳腺癌患者进行了随访.结果 458例浸润性乳腺癌中发现BLBC 46例(10.0%).癌灶直径平均3.3 cm.58.7%(27/46)出现推挤性生长方式,52.2%(24/46)出现地图状坏死,30.4%(14/46)癌灶中心出现无细胞纤维化区域以及63.0%(29/46)癌灶周边和间质内有不同程度淋巴细胞浸润.癌细胞异型性明显,核分裂象多见,主要排列成不规则、紧密实性结构.Ki-67高表达(>25%)在BLBC中占43.5%(20/46).CK5/6、CK14和EGFR阳性分别见于58.7%(27/46)、43.5%(20/46)和65.2%(30/46)的BLBC病例.BLBC的3年累积生存率为66.9%,低于管腔A型乳腺癌,与HER2高表达型乳腺癌差异无统计学意义.结论 BLBC在女性浸润性乳腺癌中所占比例为10%,其组织结构和细胞形态具有一定特征性,但诊断BLBC仍必需结合其免疫表型.BLBC是预后比较差的乳腺癌亚型之一.     

中线恶性网织细胞增生症细胞来源的探讨

结合光镜和临床病理资料，对３２例高度可疑中线恶性网织细胞增生症（ＭＭＲ）重点进行免疫表型及基因重排检测的回顾性研究，结果表明：病变内异形淋巴样细胞（ＡＬＣ）ＵＣＨＬ－１表达阳性者２４例（７５％），Ｌ２６表达者ｌ例。刮片组织ＰＣＲ法基因重排检测：ＴＣＲβ基因重排检测阳性者１７例，其中ＵＣＨＬ－ｌ阳性表达者１２例，阴性者５例，ＩｇＨ基因重排检测只１例有Ｌ２６表达者为阳性，其余均为阴性。本结果从基因水平证明ＭＭＲ本质上大多数为结外Ｔ细胞性淋巴瘤，但也可来源于Ｂ淋巴细胞。免疫表型和基因重排检测有互补性。ＭＭＲ由于其细胞成分复杂和病理形态多样，应注意与炎性肉芽组织和未分化癌鉴别。在文内还讨论了常规石蜡切片的刮取组织进行基因重排的意义。     

人脐血来源MSCs的主要生物学特性的研究

目的：探讨人脐血间充质干细胞（MSCs）分离、纯化、扩增、表面标志、免疫表型及其造血生长因子（HGFs）分泌等生物学特性方法：(1) Ficoll法分离、纯化人脐血、成人骨髓和胎儿骨髓MSCs，动态观察不同来源MSCs的生长状况。(2) 流式细胞仪检测脐血和骨髓MSCs表面CD34、CD45、CD14、CD29、CD44、CD105、CD166、CD80、CD86、CD40和CD40L的表达。(3) ELISA法检测脐血和骨髓MSCs培养上清中SCF、TPO、FLT-3L和IL-6的分泌水平。结果：(1) 所有骨髓标本中均可分离纯化出MSCs，而15份脐血中仅4份分离纯化出MSCs，脐血MSCs和骨髓MSCs的细胞形态无明显差异,脐血MSCs原代培养所需要的单个核细胞（MNC）量为骨髓MSCs的3倍，且其原代培养的增殖速度较慢，但脐血MSCs传代培养的增殖速度和骨髓相似。(2) 脐血MSCs和骨髓MSCs表面标志无差异，均不表达造血细胞表面标志以及与免疫识别有关的表面抗原。(3) 脐血和骨髓MSCs分泌SCF、TPO、FLT-3L和IL-6的水平相似。结论： (1)脐血和骨髓同样可以分离、纯化MSCs，但脐血中MSCs的含量少，且大部分脐血中不含MSCs。(2)纯化的脐血MSCs扩增能力、表面标志、免疫学表型及HGFs分泌水平和骨髓MSCs相似。