摘要目的 探讨T细胞受体(TCR)基因克隆性重排检测在蕈样霉菌病(MF)诊断中的意义,以及适用于通过石蜡包埋组织诊断MF的引物组合模式.方法 对19例MF石蜡包埋组织采用10种抗体(βF1、CD2、CD3ε、CD4、CD7、CD8、CD20、CD45RO、CD68和CD79a)进行免疫表型检测,运用PCR技术检测TCR-β、TCR-γ基因克隆性重排,并对不同TCR-β和TCR-γ引物组合的阳性检出率进行统计学分析.结果 19例MF组织均检测到TCR基因克隆性重排,其中84.2%检出TCR-γ基因克隆性重排,31.6%检出TCR-β基因克隆性重排.引物TVG/TJX、V2～5/V8～12/JGT1和BIOMED-2-TCR-γ的TCR-γ基因阳性检出率分别为47.4%、78.9%和31.6%,V2～5/V8～/JGT1的阳性检出率高于TVG/TJX和BIOMED-2-TCR-γ(均P＜0.05),引物Vγ11/Vγ101/Jγ12、Vγ11/Vγ101/Jp12均未检出TCR-γ基因克隆性重排.结论 PCR检测TCR基因克隆性重排是诊断MF的有效辅助手段,TCR-γ基因是该检测的良好靶基因,引物TVG/TJX、V2～5/V8～12/JGT1和BIOMED-2-TCR-γ均可用于MF患者的临床检测,其中以V2～5/V8～12/JGT1为首选.

abstractsObjective To investigate the significance of detecting TCR gene clonal rearrangement in the diagnosis of mycosis fungoides (MF) and to optimize the primers used for detecting the TCR gene clonal rearrangement with PCR in paraffin embedded tissues of MF. Methods Nineteen cases of MF were enrolled into the study. A panel of 10 antibodies were used for immunophenotypic analysis and polymerase chain reaction for TCR-γ and TCR-β gene rearrangement detection in this study. Results TCR gene clonal rearrangements were detected in all 19 cases, in which 84.2% cases (16/19) had TCR-γ gene clonal rearrangements. The positive rates of the primers TVG/TJX, V2-5/V8-12/JGT1 and BIOMED-2-TCR-γ were 47.4%, 78.9% and 31.6%, respectively. The positive rate of V2-5/V8-12/JGT1 was statistically significantly higher than that of TVG/TJX and BIOMED-2-TCR-γ (P ＜ 0.05). No TCR gene clonal rearrangement was detected using the primers Vγ11/Vγ101/Jγ12 and Vγ11/Vγ101/Jp12. TCR-β gene clonal rearrangement was detected in 31.6% (6/19)cases. Conclusions TCR gene clonal rearrangement analysis is a useful tool in the diagnosis of MF and TCR-γgene is a good target gene for the detection. The primers TVG/TJX, V2-5/V8-12/JGT1 and BIOMED-2-TCR-γ can be used in clinicopathologic detection for TCR gene clonal rearrangement and V2-5/V8-12/JGT1 may be the first choice.