蕈样肉芽肿浸润性皮损中树突细胞表型特征的研究

目的 探讨蕈样肉芽肿(MF)皮损中树突细胞(DC)表型及其临床意义。方法 检测DC表面分子的单克隆抗体和免疫组化技术。结果 MF斑片／斑块期的表皮及真皮浅层内存在大量的未成熟DC和成熟DC，主要是CD1a^ 、CD1c^ 、Lag^ ／Langerin^ 未成熟DC和CD83^ DC-Lamp^ 成熟DC。肿瘤期的真皮内也见大量的CD1a^ 、CD1c^ 未成熟DC和CD83^ DC-Lamp^ 成熟DC，但Lag^ ／Langerin^ DC更多见于表皮和真皮浅层．真皮深层少见，而此处CD1a^ 、CD1c^ 未成熟DC明显增多。结论 在MF斑片／斑块期，表皮朗格汉斯细胞发生了迁移，可能参与了抗肿瘤免疫反应，而肿瘤期真皮内大量CD1a^ DC可能对相应的免疫耐受产生作用。     

Rapid on‐site evaluation of EUS–FNA by cytopathologist: An experience of a tertiary hospital

Endoscopic ultrasound‐guided–fine‐needle aspiration (EUS–FNA) is the preferred modality nowadays for the cytological diagnosis of various mediastinal and gastrointestinal lesions. Onsite cytopathology interpretation is not available in most centers. The objective of this study is to assess whether rapid on‐site evaluation (ROSE) by cytopathologist of the tissue samples improves the diagnostic accuracy of EUS–FNA. This study is a retrospective review of all 646 patients undergoing EUS–FNA between January 2009 and October 2012 in our hospital. Patients in group I had cytology slides prepared by an endoscopy nurse. Patients in group II had cytology slides prepared, stained and assessed for adequacy of tissue sampling by a cytopathologist onsite. The adequacy of the samples and the final cytopathological diagnosis (definitely positive, definitely negative, inconclusive, or inadequate) was compared between the two groups. A total of 425 EUS–FNA procedures were performed in 375 patients in group I and 271 EUS–FNA procedures in 271 patients in group II. The mean of needle passes in group I was 3.12 passes per patient and 3.24 passes in group II. The difference in the number of needle passes was not statistically significant (P = 0.30). The final diagnosis was definite in 64.8% in group I compared with 97.7 % in group II (P = 0.001). The percentage of inconclusive and inadequate diagnoses was 5.6% and 29.3%, respectively in group I and 0% and 2.3% in group II (P = 0.001). In conclusion, ROSE by cytopathologist and interpretation significantly improves the diagnostic yield of EUS–FNA. Diagn. Cytopathol. 2013;41:1075–1080. © 2013 Wiley Periodicals, Inc.     

蕈样肉芽肿皮损中树突细胞和凋亡的研究

目的探讨细胞凋亡与蕈样肉芽肿(MF)疾病进程和树突细胞(DC)的关系。方法皮肤肿瘤组织冰冻切片,单克隆抗体免疫组化多染及TdT介导的dUTP缺口末端标记技术(TUNEL)。结果MF斑片斑块期肿瘤组织Pautrier微脓肿内及真皮T细胞浸润区内可见少量凋亡细胞或凋亡小体,肿瘤期真皮T细胞浸润区内可见大量凋亡瘤细胞或凋亡小体(P<0.01)。部分肿瘤组织真皮深层凋亡细胞成片分布,这些区域常见许多未成熟的DC及包绕吞噬有凋亡瘤细胞或凋亡小体的未成熟的(Lag ,CD1a )DC存在,斑片及斑块期不易见到这种现象。结论凋亡瘤细胞或凋亡小体的出现和增多可能是MF疾病进展的一个病理征象,肿瘤期中包绕吞噬凋亡瘤细胞或凋亡小体的未成熟的CD1a DC出现提示在诱导抗肿瘤免疫方面存在交叉呈递,可能诱导抗肿瘤免疫耐受。     

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。