朗格汉斯细胞源性肿瘤研究进展

朗格汉斯细胞肿瘤是一类起源于朗格汉斯细胞(LC)并保持其特定表型谱及超微结构特征的肿瘤,根据细胞形态学、免疫组化和超微结构特征,主要分为2个亚类:朗格汉斯组织细胞增生症(LCH)和朗格汉斯细胞肉瘤(LCS)。LCH是一种LC的良性克隆增殖性疾病,而LCS则是一种极其罕见的以LC恶性增殖及播散为主要特征的恶性肿瘤,被认为是LCH的高级别恶性型。两者均可累及全身各组织器官,临床表现复杂多样,程度不同。诊断主要依靠病理组织细胞形态学及免疫组织化学,必要时电子显微镜辅助诊断。治疗方面包括手术切除、放化疗、免疫治疗及造血干细胞移植等,目前尚缺乏公认最优治疗方案,治疗需个体化。LCH预后主要与受损器官数目有关,而LCS侵袭性强,进展迅速,总体预后差。本文分别就LCH和LCS的发病机制、临床表现、诊断、治疗及预后等方面进行综述。

The research progress on langerhans cell tumor - review

Langerhans cell tumor is a kind of tumor that originates from Langerhans cells (LC) and maintain their specific phenotype profile and ultrastructural features. Based on cell morphology, immunohistochemical and ultrastructural characteristics, Langerhans cell tumor has two main subcategories: Langerhans cell histiocytosis (LCH) and Langerhans cell sarcoma (LCS). LCH is a benign clonal proliferative disease of the LC, whereas LCS is an extremely rare neoplastic proliferation of Langerhans cells with overtly malignant cytologic features and spreads aggressively, which is considered to be a high level malignant type of LCH. Both LCH and LCS can involved various tissues and organs and have complex and diverse clinical manifestation, which cause different severity. The diagnosis depends on histopathological morphology and immunohistochemistry; the electron microscopy was used to assists diagnosis when necessary. The treatment includes surgery, chemotherapy, radiotherapy, immunotherapy and hematopoietic stem cell transplantation, etc, but lack of generally accepted optimal treatment options currently, individualized treatment is needed. The prognosis of LCH is primarily related to the number of damaged organ, while LCS has a poor overall prognosis as its invasion and rapid progress. This article reviews the pathogenesis, clinical manifestations, diagnosis, treatment and prognosis of both LCH and LCS.