不明原因发热患者检测淋巴细胞IgH和TCR基因重排的意义

Significance of detecting lymphocyte Ig H and TCR gene rearrangement in patients with fever of unknown origin

目的:探讨不明原因发热(FUO)患者淋巴细胞免疫球蛋白重链(Ig H)和T细胞受体-γ(TCR-γ)基因重排的临床意义。方法:采用半巢式PCR方法检测110例FUO患者骨髓淋巴细胞Ig H和TCR-γ基因重排的阳性率。结果:84例淋巴瘤发热患者中,Ig H基因重排阳性34例,TCR-r基因重排阳性29例,两者阳性率达75%;26例非淋巴瘤发热患者中,Ig H基因重排阳性0例,TCR-r基因重排阳性1例,基因重排阳性率3.8%,差异有统计学意义(P<0.05)。结论:对于FUO患者行基因重排有助于淋巴瘤的早期诊断,特别是对无法取得病理组织的患者意义更大。

Objective： To explore the clinical significance of lymphocyte Ig H and TCR-γ gene rearrangement in patients with fever of unknown origin（ FUO）. Methods： The positive rate of bone marrow lymphocyte Ig H and TCR-γ gene rearrangement was detected by semi-nested PCR method in 110 patients with FUO. Results： Lymphocyte Ig H and TCR-γ gene rearrangement were positive in 34 cases and 29 cases respectively among 84 lymphoma patients with FUO,with a total positive rate of 75%,but in 26 cases with non lymphoma FUO only one patient（ 3. 8%） showed TCR-γ gene rearrangement,the difference was statistically significant（ P 0. 05）. Conclusions： For patients with FUO detection of gene rearrangement is helpful for the early diagnosis of suspected lymphoma,especially for those whose pathological tissue can not be obtained easily.