| Background: The skin-associated lymphoid tissue(SALT) is an important immune part in humans. Primary cutaneous lymphoma (PCL) is the third most common group of extranodal non-Hodgkin lymphomas just after the groups of primary gastrointestinal and oropharynx lymphomas. The classification of PCL is very complex,which generally is classified into cutaneous T-cell lymphoma(CTCL)and cutaneous B-cell lymphoma (CBCL).It is showed that there is considerable variation in histology,phenotype and prognosis in PCL.Patients with PCL would be treated based on a correct classification. So it is very important that we investigate some indices to reflect maliganant degrees of of PCL.objective:By comparing the histological, immunohistochemical and prognostic features in mycosis fungoides(MF) and non-MF of CTCL,it provides some evidences to make diagnosis and therapy of CTCL. Methods:The specimens were collected from the cases of PCL which were diagnoised clinically and histologically from Jan,1980 to June,2002 in our department. With immunohistochemical staining, we classified the PCL into CTCL and CBCL.Then CTCL were classified into MF,non-MF(including CD30+CTCL and CD30-CTCL). The immunohistochemistry,quantitative image analysis of p53, tumor necrosis factor α (TNF-α), Ki-67, silver stained nucleolar organizer region (AgNOR) and the nucleus of pathological morphology were studied in CTCL. The negative control was used phosphate buffered saline (PBS) to replace monoclonal antibody. The normal control included the specimen from the cases of chronic dermatitis.Results: 1. According to the clinical characteristics, pathology and immunohistochemistry, we divided 34 cases of CTCLs into the MF , non-MF CD30+CTCL and non-MF CD30-CTCL groups. Among them, MF was 19 cases, non-MF CD30+CTCL 6 cases and non-MF CD30-CTCL 9 cases.2. The expression of p53,TNF-α ,Ki-67 was examined in all cases respectively, and was analyzed through statistic, showing the significant difference among various types. The expression of p53 in CTCL increased significantly (p<0.01). The average optical density(AOD) and integrated optical density(IOD)of p53 were higher in MF group than in normal group(p<0.01),and the similar situation happened between non-MF CD30-CTCL and non-MF CD30+CTCL groups.But there was not statistic difference between MF group and CD30+ CTCL group.The AOD and IOD of TNF-α in MF group were higher than those in normal group(p<0.01),but there was little difference between MF and CD30+CTCL,CD30+CTCL and CD30-CTCL, or MF and CD30-CTCL respectively.There was significant difference of AOD and IOD of Ki-67 between normal and MF groups, MF and CD30-CTCL groups,CD30+CTCL and CD30-CTCL groups (p<0.01 or p<0.05).3. The AgNORs/cell ,AOD and IOD of AgNOR in four groups showed distinctive difference.They increased according to the malignant degrees of CTCL.But there was little difference in AgNORs/cell and AOD between MF and CD30+CTCL groups.4. The AOD,IOD, and form factor (FF) of the nucleus between MF and normal groups showed the statistical difference,while between CD30+CTCL and CD30-CTCL groups.only the IOD of the nucleus was significantly different.Conclusion: At present study, we successfully completed classification of the CTCL,and analysed the difference of p53,TNF-α,Ki-67,AgNOR and nucleus measure among different groups of CTCL.The results suggested that: the differences of p53,Ki-67,AgNORs count and nucleus measure reflected the malignant degrees of CTCL. The methods of immunohistochemistry,silver stain and nucleus measure were simple and cheap.They could be applied for the clinical diagnosis and guideline of treatment... |
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