研究分析 B 细胞淋巴瘤 IgH/IgK 基因重排临床意义

Study on the clinical significance of detecting IgH/IgK rearrangements in the patients with B-cell lymphoma

目的：探讨 IgH/ IgK 基因重排在 B 细胞淋巴瘤早期诊断中的应用及临床意义。方法实验组研究对象为2013年3月至2015年4月50例淋巴瘤患者病理石蜡组织标本，选取12例淋巴结炎性肿大患者作为阴性对照组。从石蜡切片组织中提取基因组 DNA，通过多重引物聚合酶链反应扩增目的 DNA，利用异源双链技术对产物进行毛细管电泳分析，检测基因重排的阳性率，并与对照组进行对比，分析 IgH/ IgK 基因重排的发生与 B 细胞淋巴瘤患者血浆 LDH 水平的关系。结果实验组淋巴瘤患者有45例重排阳性（90％），对照组淋巴结炎性肿大患者基因重排均为阴性（P ＜0.05），IgH/ IgK 基因重排阳性患者 LDH 水平升高率为91.1％，阴性患者水平升高率为40％，差异有统计学意义（P ＜0.05）。结论基因重排可作为淋巴瘤早期诊断的特异性指标，且与患者血浆 LDH水平有相关性。

Objective To investigate the clinical significance of IgH/ IgK gene rearrangement in the early diagnosis of B cell lymphoma. Methods DNA was extracted from paraffin embedded tissues in 50 lymphomas,and 12 lymphonode inflammation（negative controls）. The gene rearrangements were am-plified by multiplex primer polymerase chain reaction,analyzed by double stranded heterologous for capil-lary electrophoresis and compared with results of pathological biopsy. The correlation between IgH/ IgK gene rearrangement and LDH level in patients with B cell lymphoma was analyzed. Results Totally 45 cases of lymphomas were positive for PCR rearragement using heteroduplex technique detecting,while 12 cases of Lymphonode inflammation were all negative（P 〈 0. 05）. LDH levels in IgH/ IgK positive patients were 91. 1% ,and the level of negative patients was 40% ,the difference was statistically significant（P 〈0. 05）. Conclusions The gene rearrangements might be used as a specific indicator for early diagnosis of lymphomas,and it might be related with scrum LDH level.