免疫球蛋白重链和T细胞受体γ基因重排在非霍奇金淋巴瘤中检测的临床意义

Significance of Clonal Immunoglobulin Heavy Chain and T-cell Receptor γ Gene Rearrangements in Non-Hodgkin Lymphoma

目的 :探讨免疫球蛋白重链 ( Ig H)和 T细胞受体 γ( TCRγ)基因重排在非霍奇金淋巴瘤( NHL )中的检测意义。方法 :用 PCR方法检测 2 5例 NHL和 1例反应性淋巴结炎患者 ,及 2 0例正常人骨髓、周围血和 /或淋巴结单个核细胞 ( MNCs)中克隆性 Ig H、TCRγ基因重排。结果 :克隆性Ig H和 /或 TCRγ基因重排在 2 5例 NHL 中检出为 84.0 % ( 2 1 / 2 5 ) ;克隆性 Ig H基因重排在 B-NHL和 T-NHL中检出分别为 86.7% ( 1 3 / 1 5 )和 2 0 .0 % ( 2 / 1 0 ) ,克隆性 TCRγ基因重排分别为5 3 .3 % ( 8/ 1 5 )和 80 .0 % ( 8/ 1 0 )。 1例反应性淋巴结炎和 2 0例正常人均未检测到 Ig H和 TCRγ基因重排。结论 :Ig H、TCRγ基因重排检测有助于 NHL 的诊断和鉴别诊断 ,及发现 NHL

Objective:To evaluate the significance of clonal immunoglobulin heavy chain(IgH) and T cell receptor γ(TCRγ) gene rearrangements in non Hodgkin's lymphoma(NHL).Methods:IgH and TCRγ gene rearrangements were studied with PCR in 25 cases of NHL and 1 of reactive follicular lymphadenosis.Twenty cases of normal subjects were used as control.Bone marrow,peripheral blood or lymph node samples were taken respectively from those patients and normal subjects.Results:Clonal gene rearrangements of IgH and/or TCRγ were found in 84.0%(21/25) of NHL patients.Clonal IgH gene rearrangement was detected in 86.7%(13/15) of B NHL and in 20.0%(2/10) of T NHL respectively .Clonal TCRγ gene rearrangement was detected in 80.0%(8/10) of TNHL and in 53.3%(8/15) of B NHL respectively.There were no clonal gene rearrangements detected in 1 case of reactive follicular lymphadenosis and 20 normal subjects.Conclusion:The detection of clonal gene rearrangements of IgH and/or TCRγ may be used in diagnosis and differential diagnosis of NHL as well as in detection of minimal disease in bone marrow from NHL.