BIOMED-2聚合酶链反应Ig基因重排对成熟非霍奇金B细胞淋巴瘤诊断的价值

Assessment of BIOMED-2 assays for detection of clonal Ig gene rearrangements in mature B-cell lymphomas

目的探讨BIOMED-2聚合酶链反应（PCR）在成熟非霍奇金B细胞淋巴瘤（B-NHL）诊断中的价值。方法收集成熟B—NHL组织标本72例，其中弥漫性大B细胞淋巴瘤37例，黏膜相关淋巴组织结外边缘区淋巴瘤35例为研究对象，并以反应性增生病变25例作为对照。提取以上组织的DNA，并以PCR来检测其完整性和可扩增性，选取质量合格的DNA。85．6％（83／97）的样品DNA长度〉300bp，其中60例成熟B—NHL和23例反应性增生可用于BIOMED-2 PCR检测免疫球蛋白重链（IgH）和kappa轻链（IgK）基因重排的克隆性。结果利用BIOMED-2 PCR检测的60例成熟B—NHL中，57例存在Ig基因的克隆性重排，其检测敏感性为95％，23例反应性增生病例中未出现Ig基因的克隆性重排，其检测特异性为100％。结论BIOMED-2 PCR适用于石蜡包埋组织。该方法具有很高的敏感性和特异性，对成熟B—NHL诊断的辅助价值很高。

Objective To evaluate the efficiency of the BIOMED-2 PCR assay and its implication in the diagnosis of mature B-cell non-Hodgkin＇ s lymphomas. Methods Clinical, morphological and immunohistochemieal features of 72 cases of non-Hodgkin＇s lymphomas were studied, including 25 reactive lymphoid hyperplasia, 37 diffuse large B cell lymphomas （DLBCL） and 35 extranodal marginal zone lymphomas of mucosa associated lymphoid tissues （ MALT lymphoma and in addition, 25 cases of reactive lymphoid hyperplasia were used as the controls ）. DNA was exacted from the paraffin embedded formalin fixed tissue blocks and the quality of DNA was assessed using the BIOMED-2 specimen control reaction. Adequate samples were then analyzed by BIOMED-2 for immunoglobulin heavy and kappa light chain rearrangements. Results Adequate DNA was obtained in 83 of 97 samples, including 60 mature B cell lymphomas and 23 reactive lymphoid hyperplasia. Clonal B-cell gene rearrangements were detected in 57 of 60 （95 % ） lymphomas. In contrast, elonal Ig gene rearrangements were not detected in any of the 23 cases of reactive lymphoid hyperplasia. Conclusion BIOMED-2 assay is highly sensitive and specific for the detection of clonal B cell gene rearrangement using routine paraffin embedded formalin fixed specimens.