石蜡包埋B细胞淋巴瘤组织克隆性IgH基因重排的检测

Determination of clonal immunoglobulin heavy chain gene rearrangement in paraffin-embedded tissues from B-cell lymphomas

目的 探讨克隆性免疫球蛋白重链第三互补决定簇区 (IgHCDR3)基因重排在B细胞非霍奇金淋巴瘤 (B NHL)诊断方面的价值。方法 采用半巢式PCR、聚丙烯酰胺凝胶电泳 (PAGE)及银染技术 ,检测 38例B NHL、4例T NHL及 10例慢性扁桃腺炎 ,经福尔马林固定、石蜡包埋病理组织的克隆性IgHCDR3重排。结果 2 9例B NHL及1例免疫组化未能明确细胞来源的NHL克隆性IgHCDR3重排阳性 ;4例T NHL及 10例慢性扁桃腺炎克隆性IgHC DR3重排阴性。结论 克隆性IgHCDR3重排可作为B NHL与反应性增生鉴别的特异性标志 。

Objective To evaluate the significance of clonal gene rearrangement of the third complementarity determining region of immunoglobulin heavy chain (IgHCDR3) in the diagnosis of B cell non Hodgkin's lymphoma (B NHL). Methods Semi nested polymerase chain reaction, polyacrylamide gel electrophoresis and silver staining were used to detect clonal IgHCDR3 gene rearrangement in formalin fixed and paraffin embedded tissues from 38 cases of B NHL, 4 T NHL and 10 chronic tonsillitis. Results Clonal IgHCDR3 rearrangements were detected in 78.4% of B NHL (29/37) and one case of NHL that the lineage of tumor cells was unknown by immunohistochemical staining. Negative results were seen in 4 cases of T NHL and 10 chronic tonsillitis. Conclusion Clonal IgHCDR3 gene rearrangement can be used as a specific molecular marker for differential diagnosis of B cell tumors from reactive lymphoproliferative diseases and as a B cell lineage marker in most cases.