掌纤维瘤病的克隆性分析

Clonality study of palmar fibromatosis

目的通过人雄激素受体(HUMARA)基因位点克隆性分析技术确定掌纤维瘤病是否为肿瘤性增生。方法收集12例女性掌纤维瘤病患者的组织蜡块,连续切片、HE染色后,采用激光显微切割技术获取梭形细胞丰富的区域,1例女性直肠腺癌组织蜡块作为阳性对照。酚-氯仿抽提DNA后,经甲基化敏感的HpaⅡ限制性内切酶消化,聚合酶链反应(PCR)扩增HUMARA基因,PCR产物经8%非变性聚丙烯酰胺凝胶电泳分离,凝胶成像系统分析。结果作为阳性对照的直肠腺癌被验证是单克隆起源的,说明了本实验的克隆性分析方法的有效性。12例掌纤维瘤病石蜡组织标本中,3例标本未扩增成功;1例标本的HUMARA基因为纯合子,不适于克隆性分析;其余8例标本在HpaⅡ酶切前后均显示2条条带,经凝胶成像系统软件分析2条条带的亮度相近,说明掌纤维瘤病是多克隆性增生。结论掌纤维瘤病是多克隆性增生,属于非肿瘤性增生。

Objective To study the clonality of palmar fibromatosis by molecular genetic analysis of X chromosome inactivation pattern at a polymorphic site of human androgen receptor gene （HUMARA）. Methods Twelve female cases of palmar fibromatosis were enrolled into this study. Hematoxylin and eosinstained sections of paraffin-embedded, formalin-fixed tissues were microdlssected by laser capture microdlssection technology in order to obtain the proliferative spindle cells. Tumor cells isolated from rectal adenocarcinoma in a female patient were used as positive control. The genomic DNAs were extracted with phenol and chloroform, digested with methylation-sensitive restriction endonuclease Hpa Ⅱ , and amplified by polymerase chain reaction （PCR） using primers targeted to a highly polymorphic short tandem repeat of HUMARA. The amplimers were separated on vertical 8% non-denaturing polyacrylamide gels and the patterns were visualized with ethidium bromide stain. Results The methodology for clonality analysis was validated in the positive control using rectal adenocarcinoma cells. Among the 12 cases studied, PCR amplification failed in 3 samples and 1 sample showed homozygosity which was not suitable for further analysis. Eight samples were successfully amplified and showed a random X chromosome inactivation pattern, suggesting polyclonality in these lesions. Conclusions Palmar fibromatosis is a polyclonal condition and should be considered as a form of non-neoplasmic fibroblastic proliferation.