克隆性基因重排检测在NHL诊断中的意义

Significance of detection of clonal gene rearrangement in diagnosis of non-Hodgkin's lymphoma

目的探明PCR克隆性基因重排检测（基因诊断）在NHL诊断中的意义。方法应用病理组织学、免疫组化、基因诊断方法三结合方案分析178例与会诊31例NHL诊断的作用。结果分析结果显示：以病理组织学为主，辅以免疫组化确诊NHL114例。疑难、早期、微量标本共64例与会诊31例均作了基因诊断。总的阳性率为61．4％（58／95）。其中IgH阳性13例（22．4％），TCRβ芝邱阳性41例（70．6％），双克隆性4例（7％）。本室基因诊断送检率为35．8％（64／178），总确诊率为93．7％（60／64）。结论本文分析证明基因诊断是NHL三结合诊断中确诊疑难病例及分型的最有效的方法。

Objective To explore the significance of detection of clonal gene rearrangement in diagnosis of non-Hodgkin's lymphoma (NHL). Methods Histopathology , immunohistochemistry and gene diagnosis were used to analyze 178 cases with NHL and 31 such cases for consultaion and to evaluate the role of the methods ing the diagnosis of the disease. Results There were 114 cases definitely diagnosed by primarily histopathology and assistant immunohistochemistry. Gene diagnosis was used for the diagnosis of other 95 cases that were diffcult in diagnosis or whose specimens were early in stage and small in size. The total positive rate was 61 .4% (58/95). Of the positive cases, there were 13 cases (22.4%) poaitive for IgH, 41 cases (70.6%) positive for TCR and 4 cases (7% ) were of double clone character. In this department , the gene diagnosis rate was 35 .8% (64/ 178) and total definitely confirmed diagnostic rate was 93 .7% (60/64). Conclusion It is suggested that the gene diagnosis is the most effective method for difficult cases in the diagnsis of NHL among the three methods.