摘要
目的建立克隆性免疫球蛋白重链(IgH)基因重排检测技术,探讨B淋巴细胞IgH基因重排在恶性淋巴瘤诊断的临床价值。方法选取62例B细胞性非霍奇金淋巴瘤(B-NHL),其中,弥漫大B淋巴瘤(DL-BCL)42例、滤泡性B细胞淋巴瘤(FL)15例、套细胞淋巴瘤(MCL)5例;15例未定性的淋巴组织增生性病变;20例良性淋巴组织反应性增生病例。从组织蜡块切片提取基因组DNA,经PCR扩增,聚丙烯酰胺凝胶电泳后银染显示基因重排结果。结果62例B-NHL中53例IgH基因重排(85.5%),其中DLBCL37例、FL13例、MC14例,阳性率分别为88.1%、86.7%、80.0%,各组间阳性率差异无统计学意义(P>0.05);15例未确诊的疑难病例中10例IgH基因重排,其中7例经随访或会诊确认为B-NHL;20例良性淋巴组织反应性增生病例IgH基因重排均为阴性,IgH基因重排检出率在淋巴瘤组与良性组之间差异有统计学意义(P<0.001)。结论PCR法检测B淋巴细胞IgH基因重排可作为淋巴细胞来源的良、恶性病变的一种辅助诊断手段,适用于石蜡标本,进行回顾性研究。
Objective To establish a way to detect the gene rearrangements of IgH and to assess the application of the detection technique in the diagnosis of B-cell malignant lymphoma. Methods There were 62 cases of B-cell non-Hodgkin's lymphomas (B-NHL), in which diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL) and mantal cell lymphoma (MCL) were 42, 15 and five cases respectively, 15 cases of suspected lymphomas and 20 cases of reactive lymphoid hyperplasia were chosen. Genomic DNA was extracted and amplified via PCR. The products were resolved on polyacrylamide gels (PAGE) and visualized through silver staining. Results IgH gene rearrangement was found in 53 cases out of 62 cases of B-NHL (85.5%). Among B-NHL cases, the positive rates of DLBCL, FL and MCL were 88.1%, 86.7%, and 80.0% respectively. There was not a remarkable difference among different groups of B-NHL (P〉0.05) . There was IgH gene rearrangement in 10 cases of 15 cases suspected lymphomas, among whom seven cases were diagnosed B-NHL by follow-up visit or consuhation. Gene rearrangements of IgH were negative in 20 cases of reactive lymphoid hyperplasia. There was a remarkable difference between NHL group and benign group in gene rearrangment (P〈0. 001) . Conclusion The detection of gene rearrangements of IgH by PCR can be a kind of subsidiary means to diagnose the lymphoproliferative disease. Particularly, the clonality showed in the formalin-fixed and paraffin-embedded samples may be useful in the retrospective research.
出处
《福建医药杂志》
CAS
2007年第6期77-79,共3页
Fujian Medical Journal
关键词
淋巴瘤
基因重排
聚合酶链反应
Lymphoma
Gene rearrangement
Polymerase chain reaction