为探索血管免疫母细胞性T细胞淋巴瘤(AITL)的诊断新模式,AITL31例,外周T细胞淋巴瘤28例,未另作说明的(PTCL-NOS)被用作研究对象。用CD4、CD10、Bcl-6、PD-1鉴定滤泡辅助性T细胞(TFH),用CD20和EZH2鉴定增殖性B细胞,用CD21和CD23鉴定增殖性滤泡树突状细胞(FDC),分析TFH/B/FDC增殖和免疫定位在AITL诊断中的价值。(1)固有淋巴滤泡外,在AITL中观察到TFH/B/FDC(一种新的诊断模式)的同时增殖[83.87%;26/31],他们的免疫定位在同一部位[83.87%;26/31],而在28例PTCL-NOS中未观察到这种现象(P<0.05)。(2)使用这种新模式诊断AITL的敏感性和特异性均较高(83.87%,100%),优于CD2(100%,0%),CD3(100%,0%),CD4(100%,32.14%),CD5(100%,25%),CD10(61.9%,100%),Bcl-6(42.86%,100%),PD-1(83.87%,96.43%),其Youden指数(0.84)最高。CD10,Bcl-6,PD-1和新诊断AITL的曲线下面积(AUC)分别为0.81,0.71,0.90和0.92。而新模式的AUC最高。固有淋巴滤泡外TFH/B/FDC细胞的同时增殖可用于辅助诊断AITL,TFH/B/FDC细胞的同时时空增殖是AITL的特异性免疫形态学。
In order to explore a new mode for the diagnosis of angioimmunoblastic T-cell lymphoma (AITL), 31 cases of AITL and 28 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) were used as the study subjects. Identifying T follicular helper (TFH) cells with CD4, CD10, Bcl-6, and PD-1, identifying proliferative B cells with CD20 and EZH2, identifying proliferative follicular dendritic cells (FDCs) with CD21 and CD23, and analyzing the value of TFH/B/FDC proliferation and immunolocalization in the diagnosis of AITL. (1) Outside the inherent lymphoid follicles, simultaneous proliferation of TFH/B/FDC (a new diagnostic mode) were observed in AITL [83.87%; 26/31], with their immunolocalizations in the same site [83.87%; 26/31], while this phenomenon was not observed in 28 cases of PTCL-NOS (P<0.05). (2) The sensitivity and specificity of using this new mode to diagnose AITL were both high (83.87%, 100%), which was superior to CD2 (100%, 0%), CD3 (100%, 0%), CD4 (100%, 32.14%), CD5 (100%, 25%), CD10 (61.9%, 100%), Bcl-6 (42.86%, 100%), PD-1 (83.87%, 96.43%), and its Youden Index (0.84) was the highest. The areas under the curve (AUC) of CD10, Bcl-6, PD-1, and new mode to diagnosis AITL were 0.81, 0.71, 0.90, and 0.92, respectively, while the new mode had the highest AUC. The simultaneous proliferation of TFH/B/FDC cells outside the inherent lymphoid follicles can be used to assist in the diagnosis of AITL, and the simultaneous spatiotemporal proliferation of TFH/B/FDC cells is a specific immunomorphology of AITL.