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华西医学  2012 

自然杀伤/T细胞淋巴瘤的生物学行为和临床及诊断研究进展

, PP. 455-458

Keywords: 淋巴瘤,自然杀伤/T细胞,EB病毒,病理,诊断

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Abstract:

自然杀伤(NK)/T细胞淋巴瘤(NKTCL)作为非霍奇金淋巴瘤(NHL)的独立类型,在亚洲、拉丁美洲地区发病率明显高于西方国家。其发病与EB病毒(EBV)感染关系密切,而遗传因素、农药、化学溶剂等与其发病有一定相关性。病理组织学上以血管中心和多形淋巴网状内皮细胞的破坏性浸润为特征,表达T或NK细胞抗原,以及T细胞内抗原-1、粒酶B、穿孔素等细胞毒颗粒相关蛋白,组织标本中绝大部分EBV编码的小分子RNA检测阳性。临床上以中轴区受累为多见,早期病变常局限,进展期则呈侵袭性生长、少数可发生远处转移。目前诊断主要依靠组织标本的病理学检查,CD2+、CD3ε+及CD56+可作为诊断该肿瘤较特异的免疫组织化学标记;同时,EBV相关成分及白介素-9、白介素-10和γ-干扰素等相关细胞因子和蛋白的检出对诊断具有积极帮助,卟啉钙黏蛋白15则可望成为诊断NK细胞来源肿瘤的新的重要标记。近年来,影像学检查、尤其18氟标记脱氧葡萄糖正电子发射型计算机断层扫描显像仪对诊断的价值更加受到重视,有利于与B细胞来源淋巴瘤鉴别,并对NKTCL的分期及预后判断有一定价值。

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