鼻腔及咽淋巴环恶性淋巴瘤的免疫组化与基因重排检测

Immunophenotype and gene rearrangement analysis for malignant lymphoma of nasal cavity and Waldeyer's ring

对４３例鼻腔及咽淋巴环非何杰金淋巴瘤（Ｎｏｎ－Ｈｏｄｇｋｉｎ＇ｓＬｙｍｐｈｏｍａ，ＮＨＬ）重点进行了免疫表型和基因重排检测，其中鼻腔２５例、咽淋巴环１８例。免疫表型检查结果４３例ＮＨＬ中，ＵＣＨＬ－１和Ｌ２６表达阳性各为２６和７例，１０例无确切免疫表型表达，常有ＵＣＨＬ－１和Ｌ２６阳性细胞同时存在于组织中；ＴＣＲβ和ＩｇＨ基因重排检测：４１例中２８例出现特异性基因重排扩增单带，其中２１例ＴＣＲβ基因重排检测阳性，７例ＩｇＨ阳性，包括１２例ＵＣＨＬ－１和６例Ｌ２６阳性表达者和１０例无确切免疫表型表达者；１例高度反应性增生病例ＴＣＲβ基因重排检测阳性，２例低分化癌和２例淋巴组织高度反应性增生均为阴性。结果表明，免疫表型和基因重排检测有一定互补性；同时讨论了用常规石蜡切片的刮取组织进行基因重排检测的意义。

cases of nasal cavity and pharyngeal Waldeyer's ring non-Hodgkin's lymphoma (NHL) were investigated for immunophenotypic expression (UCHL-1 for T lymphocytes and L26 for B cells) and TCRβ or IgH gene rearrangement. The immunostaining was processed by Vacuum ABC method. Scrapped tissue from stained and unstianed formalin-fixed paraffin-embedded tissue sections were used for PCR gene rearrangement analysis : The results showed that among 43 cases 26 expressed UCHL-1 marker and 7 were positive for L26 staining. It is not uncommon that UCHL-1 and L26 positive cells were coexisted in the lesion. 28 of 41 cases were positive for gene rearrangement analysis; among them 21 showed TCRβ monoclonal gene rearrangement and 7 cases were IgH positive, including 12 cases positive for UCHL-1 and 6 positive for L26 expression and 10 cases negative for both UCHL-12 and L26 markers. A case of highly reactive hyperplasia of lymph tissue was found to be positive for TCRβ gene rearrangement analysis. The results demonstrated that immunophenotype and gene rearrangement examinations were mutually supplementary. The significance of gene rearrangement analysis made by scrapped tissue from formalin-fixed paraffin-embedded tissue section was discussed.