采用PCR检测淋巴结细胞IgH和TCRγ基因重排对淋巴增殖病的诊断意义  

DETECTION OF IgH AND TCR_γ GENES REARRANGEMENT IN LYMPH NODE CELLS WITH PCR: DIAGNOSTIC SI GNIFICANCE FOR LYMPHOPROLIFERATIVE DISORDERS

作　　者：王鲁群 马晓星[1] 张明珙[2] 宋素芹[2] 

机构地区：[1]济南总医院血液科,济南250031 [2]山东医科大学血液病研究室,济南250012

出　　处：《中国实验血液学杂志》1994年第4期385-389,共5页Journal of Experimental Hematology

摘　　要：采用PCR体外基因扩增技术研究10例活检淋巴结细胞IgH和TCRγ基因重排,并与组织病理和免疫表型分析进行了对比研究。结果表明:6例病理诊断为非何杰金淋巴瘤(NHL)者中,4例发生相应的IgH或TCR_γ基因克隆性重排,与免疫表型分析一致,另2例同时发生了IgH和TCR_γ基因双重重排。2例病理诊断为坏死性淋巴结炎者,免疫表型分析起源于B细胞,均检测到IgH基因克隆性重排,证明系克隆性恶性B淋巴细胞增殖。表明用PCR检测IgH和TCR_γ基因重排,对恶性淋巴细胞增殖病诊断的敏感性和特异性高于组织病理学和免疫表型分析,具有重要临床应用价值。It is difficult to distinguish malignant from reactive lymphoproliferation using histopathologic method and to determine the origin of malignant lymphoproliferation exactly. Though the analysis of immunophenotype might be used to determine the cell origin and stage of differentiation of lymphoproliferation, it can not discern tumor cells specially, because no specific antigen of lymphoid malignant cells has been found up to now. So founding a sensitive and specific method may be very useful for detecting lymphoproliferative disorders. Using an advanced molecular biologic method-polymerase chain reaction for amplifying IgH and TCRγgenes rearrangement in biopsy of lymph node cells in vitro, ten patients with lymphoproliferative disorders were studied and its clinical practical value on the basis of comparing with histopathologic and immunologic methods was estimated. In all 10 patients, 4 cases expressing B cell surface markers the clonality rearrangement of IgH gene was detected, 2 of them were diagnosed necrotic lymphadenitis with histopathology and 2 were non-Hodgkin's lymphoma. 2 Cases expressing T cell surface antigens and diagnosised non-Hodgkin's lymphoma the clonality rearrangement of TCRy gene was found. Of other 2 cases of non-Hodgkin's lymphoma, one expressing pre B cell surface markers and the other expressing pre-T cell surface antigens were all detected to have the double- rearrangement of IgH and TCRy genes. No rearrangement of IgH and TCRy genes were detected in 2 patients with reactive lymphadenitis. The clonality rearrangement of IgH and TCRy genes may serve as malignant molecular markers of lymphoid clonal proliferations for diagnosis of the malignant lymphoproliferative disorders in early stage and detection of the minimal residual diseases after therapy. Its sensitivity and specificity were higher than those of histopathologic and immunologic methods.

关 键 词：聚合酶链反应 淋巴结 基因重排 淋巴细胞增殖病 

分 类 号：R55[医药卫生—血液循环系统疾病]