A Study Of Clinical Features,Treatment And MiRNA Expression Characteristics Of Unilesional Mycosis Fungoides

Objective:(1)To study the clinical features,treatment and prognosis of unilesional mycosis Mycosis(UMF),and to summarize the best treatment strategy.(2)To explore the expression characteristics of miRNA in UMF to provide reference for the early diagnosis of the disease.Materials and methods: 16 cases of UMF patients were collected in our department from 2002 to 2017.Clinical and pathological features,laboratory examination and follow-up data were analyzed to summarize the pathogenic features and the best treatment strategy;The FFPE specimens of 10 cases of UMF,7 cases of non unilesional early stage MF patients were selected as the experimental group,5 cases of benign inflammatory skin disease(2 cases of psoriasis and 3 cases of eczema)were used as the control group,RT-PCR was conducted to detect the expression of 5 kinds of MF related miRNAs and statistical analysis was followed.Results:(1)The age of 16 patients including 7 males and 9 females ranges from 14 to 70 years old,with an average age of 36 years.The age of diagnosis ranges from 15 to 70 years old,with an average age of diagnosis of 39 years.The course of the disease ranges from 3 to 228 months,with an average course of 60 months.(2)Except for the presence of a solitary skin lesion,the skin lesions of UMF are basically consistent with the classic MF,showing patches,plaques or tumours.Most of the patients' skin lesions occur in the non-sun-exposed areas of the body.(3)14 cases of HE stained specimens from UMF patients showed histological characteristics of classic MF.Another 2 patients showed histological features of FMF.Immunohistochemistry showed that only 3 patients showed CD7 deletion,and the positive rate of TCR gene rearrangement was 82%.(4)15 cases firstly chose phototherapy while 1 case firstly chose electron beam radiotherapy,with a complete remission rate of 82%.(5)There existed significant differences in the expression of miRNA-155-5p,miRNA-200b-3p and miRNA-203a-3p between the UMF group and the benign inflammatory dermatosis group(P<0.05).Conclusion: UMF is a special subtype of MF and is clinically manifested as a solitary skin lesion,which is generally less than 5% of the body surface area(BSA).UMF lesions are polymorphous and often occur in non-sun-exposed areas of the body and rarely appear as tumors.UMF not only show the pathological characteristics of classic MF,but also possess special properties as Folliculotropic Mycosis Fungoides(FMF)or Syringotropic Mycosis Fungoieds(SMF).The immunohistochemical results show that only a few cases present CD7 deletion,and most of the cases are positive for TCR gene rearrangement,while the association between TCR gene rearrangement and prognosis is not significant.The first choice of treatment of UMF in our department is phototherapy,with high acceptance rates of the patients,and the rate of complete remission after treatment can be beyond 80%.The differential expression of miRNA-155-5p,miRNA-200b-3p and miRNA-203a-3p can provide important reference for the early differential diagnosis of UMF and benign inflammatory dermatosis.