IgH基因重排PCR分析在淋巴组织细针穿刺中的辅助诊断价值

Value of IgH gene rearrangement analysis using PCR in assistant diagnosis of lymphoproliferative disorders by fine needle aspiration

目的探讨IgH基因重排检测在细针穿刺诊断淋巴组织病变中的价值。方法收集淋巴组织细针穿刺病例159例,应用半巢式PCR检测IgH基因重排。将基因重排检测结果与细胞学诊断及组织学随访结果进行比较。结果穿刺标本中,IgH基因重排检测B-NHL阳性率为72.22%,RH阳性率仅为3.92%。本法敏感性为72.22%,特异性达到96.08%。结论IgH基因重排检测对辅助淋巴组织细针穿刺标本的良、恶性判断具有一定价值,并且单克隆性结果更有意义。但在淋巴瘤和转移性非淋巴细胞恶性肿瘤的鉴别上不建议应用。

Purpose To assess the efficacy of IgH gene rearrangement analysis in the fine needle aspiration of lymph tissue as an adjunct to cytologic diagnosis. Methods One hundred and fifty-nine cases of lymphoid tissues obtained by fine needle aspiration were collected and IgH gene rearrangements detected by PCR were examined. The results of gene rearrangements were compared with diagnoses from subsequent surgical biopsies. Results The positive rate of IgH gene rearrangement detection was 72.22% in B-NHL and zero in 4 cases of T-NHL. In 102 cases of reactive lymphnodes aspiration, only 4 had moneclonality result. The specificity was 96.08%. Conclusions For fine needle aspiration of lymph node, determination of clonality through IgH gene rearrangement analysis is a useful diagnostic assay. But this assay is not efficient in the differentiation between Lymphoma and other metastatic malignant tumors.