免疫球蛋白重链基因重排检测在原发性胃肠道B细胞非霍奇金淋巴瘤中的应用研究

Study on application of detection of immunoglobulin heavy chain gene rearrangement in primary gastrointestinal B cell nonHodgkin lymphoma

目的探讨多聚酶链反应(PCR)检测免疫球蛋白重链基因重排在原发性胃肠道淋巴组织增生性疾病中的良恶性鉴别中的应用价值。方法选取存档蜡块45例,采用HE常规染色及SP免疫组化方法进行组织学分类,运用PCR半巢式扩增免疫球蛋白重链基因重排,2%琼脂糖凝胶电泳检测PCR产物。结果Ig H FR3A和Ig H FR3A+FR2A在MALT淋巴瘤的阳性检测率分别为60.7%(17/28)和75.0%(21/28),在DLBCL中的阳性检测率分别为60.0%(9/15)和73.3%(11/15),在MCL中的阳性检测率分别为100.0%(1/1)和100.0%(1/1)。Ig H FR3A在胃肠道淋巴瘤中的阳性检测率为60.0%。Ig H FR3A联合Ig H FR2Ad在胃肠道淋巴瘤中的阳性检出率为73.3%(33/45)。结论采用PCR方法检测免疫球蛋白重链基因重排能够作为淋巴瘤诊断的有效辅助手段,有助于对原发性胃肠道淋巴组织增生性疾病的良恶性做出正确的诊断。

Objective To explore value of polymerase chain reaction（PCR） detecting immunoglobulin heavy chain gene rearrangement in differentiation of benign and malignant of primary gastrointestinal lymphoproliferative disease. Methods 45 paraffin-embedded specimens were selected and they were received histological categories according to HE staining and SP immunohistochemistry. Immunoglobulin heavy chain gene rearrangement was amplified by semi nested PCR. 2% PCR products were detected by agarose gel electrophoresis. Results Positive detective rates of Ig H FR3 Aand Ig H FR3A＋FR2A in MALT lymphoma were 60.7%（17/28） and 75.0%（21/28） respectively. Positive detective rates in DLBCL were 60.0%（9/15） and73.3%（11/15） respectively. Positive detective rates in MCL were 100.0%（1/1） and 100.0%（1/1） respectively. Positive detective rate of Ig H FR3 A in gastrointestinal lymphoma was 60.0%. Positive detective rate of g H FR3 Acombined with Ig H FR2 Ad in gastrointestinal lymphoma was 73.3%（33/45）. Conclusion Use of PCR to detect immunoglobulin heavy chain gene rearrangement can be effective assistant method to diagnose lymphoma. It can help to make right diagnosis for differentiation of benign and malignant of primary gastrointestinal lymphoproliferative disease.