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Expression of Follicular Helper T-cell Markers in Primary Cutaneous T-cell Lymphoma

원발성 피부 T-세포 림프종의 여포성 보조 T-세포 표지자 발현에 대한 연구

초록/요약

Background and objectives: A distinct subset of T helper cells, named follicular helper T- (TFH) cells, have been recently described. The TFH-cells can be identified on the basis of the expression of several markers including: the chemokine CXCL13; the costimulatory molecules PD-1 and inducible costimulator (ICOS); and the transcription factor Bcl-6. The TFH-cells appeared to be localized in several subsets of T-cell lymphomas. However, their localization in cutaneous T-cell lymphomas has been rarely described. In this study, the clinical features, histopathological morphology, and expression of TFH markers in cutaneous T-cell lymphomas were investigated. Materials and methods: Forty-nine Korean patients (24 men, 25 women) diagnosed with cutaneous T-cell lymphoma were examined: 25 patients with mycosis fungoides (MF), 9 with lymphomatoid papulosis, 8 with anaplastic large cell lymphoma, 4 with subcutaneous panniculitis-like T-cell lymphoma, 2 with peripheral T-cell lymphoma, and 1 with NK/T-cell lymphoma. Chart review was performed to evaluate the clinical features. Hematoxylin and eosin (H&E) staining was used to study the general histopathological changes. Additionally, immunohistochemical staining for CD10, Bcl-6, ICOS, CXCL13, and PD-1 were performed. The extent of staining was scored from 0 to 3 by 2 independent observers. Results: PD-1 was frequently expressed in most of the MF cases, but was rarely expressed in other cutaneous T-cell lymphomas. Bcl-6, CXCL13, ICOS, and CD10 were scantly expressed in most T-cell lymphomas, including MF. Interestingly, the staining for PD-1 was negative in all the MF cases with large-cell transformation. No correlation was observed among clinical morphology, disease course, and PD-1 expression rate in the MF cases. Conclusions: Most of the MF samples expressed TFH-cell markers. This finding suggests that some MF tumor cells might consist of TFH-cells. In addition, higher PD-1 expression rates in MF than in other cutaneous T-cell lymphomas implies that PD-1 can be an MF-sensitive marker, and it might be useful in differentiating MF from other cutaneous T-cell lymphoma. The loss of PD-1 expression in large-cell–transformed MF suggests that PD-1 downregulation may be related to the processes responsible for large-cell transformation.

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목차

ABSTRACT
TABLE OF CONTENTS
LIST OF FIGURES
LIST OF TABLES
INTRODUCTION
MATERIAL AND METHODS
A. Subjects
B. Methods
1. Chart review
2. Skin biopsies
3. Staining
4. Immunohistochemical analysis
5. Evaluation of immunohistochemical staining
6. Statistical analysis
RESULTS
A. Clinical findings
B. Results of immunohistochemical staining
C. Statistical analysis
D. Relation between PD-1 expression and clinical course
DISCUSSION
CONCLUSION
REFERENCES
국문요약

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