Bcl-2基因重排在恶性淋巴瘤微小残留病变检测中的应用

Bcl 2/JH gene re arrangement determined by PCR as a means to detect minimal residual disease in malignant lymphomas

目的建立敏感的检测淋巴瘤微小残留病变（ＭＲＤ）的方法，探索Ｂｃｌ２基因重排在恶性淋巴瘤的分期、化疗疗效和预后评估中的意义。方法多聚酶链反应（ＰＣＲ）检测Ｂｃｌ２／ＪＨ基因重排，系列稀释试验检测该方法的敏感性。结果９种恶性淋巴瘤细胞系中，ＳｕＤＨＬ４，ＳｕＤＨＬ６有Ｂｃｌ２／ＪＨ基因重排，系列稀释试验检测该方法的敏感度达１∶１０５。滤泡性淋巴瘤（ＦＮＨＬ）患者１６例中，４例外周血和骨髓中同时检出Ｂｃｌ２（ＭＢＲ）／ＪＨ基因重排，化疗达ＣＲ后仍存在。结论多聚酶链反应检测Ｂｃｌ２／ＪＨ基因重排，是检测滤泡性淋巴瘤患者微小残留病变的一个快速、有效、敏感的方法，对疾病的分期、疗效和预后评估有一定的临床应用价值。

Objective To develop a sensitive method to detect minimal residual disease and to elucidate the significance of bcl 2 gene rearrangement in diagnosis and therapy of malignant lymphoma. Methods Using polymerase chain reaction(PCR) to detect bcl 2 gene rearrangement and using serial dilution method to define the sensitivity of PCR. Results In 9 different malignant lymphoma cell lines, Su DHL 4 and Su DHL 6 were shown bcl 2(MBR)/JH rearrangement, the sensitivity of PCR was 1∶10 5. In 16 patients with follicular lymphoma, the peripheral blood and bone marrow were PCR positive in 4 both at initial diagnosis and after complete remission. Conclusion Detection of bcl 2 gene rearrangement by PCR provides a sensitive and specific assay of minimal residual disease. It helps improve staging of disease, stratification and evaluation of treatment.