淋巴系统恶性肿瘤患者血清游离DNA含量与重排基因检测及其临床意义

The research of serum-DNA IgH and T-cell receptor gama gene rearrangement in lymphogenous malignant patients

目的探讨血清游离DNA含量及其克隆性重排基因检测在淋巴系统恶性肿瘤诊断中的价值。方法常规方法提取与定量分析72例淋巴系统恶性肿瘤患者血清DNA;用聚合酶链反应分别对不同患者血清单个核细胞(PBMC)DNA的特异性免疫球蛋白重链CDRⅢ区、T淋巴细胞受体γV9区序列进行扩增、检测和对照分析。结果急性淋巴细胞白血病(ALL,含B-ALL组和T-ALL组)、B-淋巴瘤组、T-淋巴瘤组患者血清游离DNA含量[分别为(418±172)μg/ml、(426±192)μg/ml、(388±170)μg/ml、(400±110)μg/ml]均高于正常对照组[(77±47)μg/ml,P<0·05]。其中46例ALL患者血清及PBMC重排基因阳性率分别为76·1%和82·6%;26例淋巴瘤患者血清及PBMC重排基因阳性率分别为73·1%和65·4%;且两种方法检测结果有较好的一致性(P>0·05)。结论淋巴系统恶性肿瘤患者血清游离DNA含量明显增高,且易检测出特征性重排基因,血清游离DNA和重排基因对淋巴系统肿瘤诊断有重要价值。

Objective To evaluate the diagnostic significance of detecting serum-DNA concentration and clonal gene rearrangement in lymphogenous malignant patients. Methods Serum-DNA in 72 diagnosed patients were measured and analyzed by SPSS11.0. Serum and mono-nuclear cells samples were collected. IgH CDRⅢ, TCRγV9 region were amplified by PCR. Results The serum-DNA concentration of disease groups were （418 ± 172） μg/ml, （426 ± 192） μml, （388 ± 170）μg/ml and（400 ± 110）μg/ml, each was higher than those of control group （ 77 ± 47 ） μg/ml （ P 〈 0. 05 ） . Among the 46 ALL cases, the gene rearrangement positive ratio of serum and mononuclear cells samples were 76. 1%, 82. 6% respectively. Among the 26 lymphoma cases, the positive ratio of serum and mononuclear cells samples were 73. 1%, 65.4% respectively. Analyzed by SPSS11.0, the positive ratio of serum sample was highly consistent with mononuclear cells sample in lymphogenous malignant patients （ P 〉 0. 05 ）. Conclusion The concentration of serum-DNAwere higher in lymphogenous malignant patients and tumor associated DNA could be easily detected, so they have important diagnostic value in lymphogenous malignant patients.