儿童淋巴系统恶性肿瘤免疫分型与IgH、TCRγ基因重排关系的初步探讨

THE RELATIONSHIP BETWEEN IMMUNOPHENOTYPE AND THE REARRANGEMENTS OF IgH AND TCRγ GENES IN CHILDREN WITH ALL AND NHL

目的了解儿童淋巴系统恶性肿瘤免疫分型与ＩｇＨ、ＴＣＲγ基因重排的关系。方法应用ＰＣＲ方法检测８１例已做免疫分型的儿童恶性淋巴瘤和急性淋巴细胞性白血病患者的ＩｇＨ和ＴＣＲγ基因重排。结果Ｂ－ＮＨＬ中，ＩｇＨ基因重排的检出率为８２．４％，ＴＣＲγ基因重排的检测率是７６．５％；Ｔ－ＮＨＬ中，ＩｇＨ基因重排率为２５％，ＴＣＲγ基因重排未检出。在Ｂ－ＡＬＬ中ＩｇＨ基因重排检出率为７４％，ＴＣＲγ基因重排检出率为５０％；在Ｔ－ＡＬＬ中ＩｇＨ基因重排检出率为３７．５％，ＴＣＲγ基因重排检出率为５０％；其中，９１％的病例至少出现一种重排。结论应用ＰＣＲ技术，通过对ＩｇＨ和ＴＣＲγ基因重排的检测，不能判断肿瘤细胞源性，对鉴定淋巴细胞增生的性质有重要意义。

Objective To investigate the relationship between immunophenotype and the rearrangements of IgH and TCRγ genes in children with ALL and NHL. Methods To detect the IgH and TCRγ gene rearrangements in 81 children with ALL and NHL whose immunophenotype had been detected. Results IgH and TCRγ gene rearrangements respectively were detected in 82.4% and 76.5%patients with B NHL.In T NHL, IgH and TCRγ gene rearrangements respectively occur in 25% and 0% patients. IgH and TCRγ gene rearrangements respectively were detected in 74% and 50% patients with B ALL. In T ALL, IgH and TCRγ gene rearrangements respectively occur in 37% and 50% patients. 91% patients at least had one of those rearrangements. Conclusion Detection for IgH and TCRγ gene rearrangements can not be used to determine the origin of malignant cells, but can be used to identify the characteristic of the lymphoproliferative cells.