摘要目的 探讨血管免疫母细胞性T细胞淋巴瘤(AITL)中B细胞克隆群的存在意义及与EB病毒(EBV)感染、临床预后的关系.方法 收集2010年5月至2014年2月诊断的33例AITL,同时选取10例非特殊类型外周T细胞淋巴瘤做对照,应用免疫组织化学、聚合酶链反应(PCR)及原位杂交方法分析其组织学特点、基因重排情况及EBV阳性率,并收集随访资料.结果 33例AITL中,Ig基因单克隆重排检出率为21.2％ (7/33),EBER阳性率为63.6％ (21/33).Ig单克隆组与Ig多克隆组EBER阳性率分别为7/7和53.8％ (14/26),两组比较差异有统计学意义(P =0.032).EBV阳性的AITL病例中,按EBV阳性数分为4个数量等级,两两比较1级、2级和3级这3组中Ig单克隆性与Ig多克隆性表达情况,差异均无统计学意义(P＞0.05).生存分析显示Ig单克隆组与Ig多克隆组的预后差异无统计学意义(P =0.263).结论 AITL中存在一定比例的Ig基因单克隆性重排,且与EBV感染密切相关,但与EBER杂交阳性模式无关.Ig基因重排与临床预后相关性存在争议,有待于补充样本进一步验证.

abstractsObjective To study the significance of B-cell clones in angioimmunoblastic T cell lymphoma (AITL) and the correlation with Epstein-Barr virus (EBV) and prognosis.Method The histopathologic features,T cell clonality and EBV positivity in 33 cases of AITL and 10 cases of peripheral T-cell lymphoma,not otherwise specified (PTCL-NOS) collected from May 2010 to February 2014 were analyzed by immunohistochemistry,PCR gene rearrangement and in situ hybridization.Follow-up data were also collected.Results Of the 33 cases with AITL,seven cases (21.2％) exhibited clonal rearrangement of Ig genes; 21 cases (63.6％) were EBV positive.Seven cases had B-cell clones and all (7/7) were EBV positive; 14 of the 26 (53.8％) cases without B-cell clones were EBV positive.The difference between the two groups was statistically significant (P =0.032).Four levels were made according to the number of EBV-labeled cells,Ig gene rearrangements,but there was no significant difference among levels 1,2 and 3.There was no correlation between B-cell clones and prognosis (P =0.263).Conclusion Clonal rearrangement of Ig genes is a common finding in AITL,and it is highly associated with EBV positivity,but not with the number of EBV-labeled cells.The clinical significance remains unclear; further study with more samples is warranted.