IgH、TCR-γ基因重排与免疫组化诊断非霍奇金淋巴瘤的价值  

Evaluation of IgH and TCRγ gene rearrangment and immunohistochemistry in diagnosis of non-Hodgkins lymphoma

作　　者：杨倩[1] 薛玲[2] 林汉良[2] 周慕珩[2] 

机构地区：[1]深圳市第二人民医院病理科,518035 [2]中山大学中山医学院病理学教研室,广州510080

出　　处：《临床与实验病理学杂志》2005年第1期50-53,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的　探讨基因重排与免疫组化在诊断非霍奇金淋巴瘤(non Hodgkin’slymphoma,NHL)中的价值。方法　对131 例NHL的石蜡包埋组织进行免疫组化和基因重排检测。结果　60例B细胞NHL中51例IgH基因重排检测为阳性,阳性率 85%;50例T细胞NHL中38例TCR -γ基因重排检测为阳性,阳性率76%;HE形态学和免疫组化分型诊断率为84%(110 例),加用IgH和TCR -γ基因重排,分型诊断率达94.6%(124例),两分型诊断率差异有显著性(P<0.05)。6例巨大淋巴结 增生和3例血管免疫母细胞性淋巴结病IgH和TCR -γ基因重排检测均为阴性。基因重排与形态学和免疫组化结果不相符的 病例有7例。结论　联合运用免疫组化和基因重排技术,可提高NHL的分型诊断率。Purpose To study the significance of gene rearrangment and immunohistochemistry in the diagnosis of non-Hodgkins lymphoma(NHL). Methods Paraffin embedded tissues of 131 cases of NHL were studied using polymerase chain reaction (PCR) to detect clonal IgH and TCR-γ gene rearrangement and immunohistochemical staining. Results 51/60 (85%) of B cell lymphomas showed positive IgH gene rearrangement; 38/50 (76%) of T cell lymphomas showed clonal TCR-γ gene rearrangement. 110 cases (84.0%) could be categorized by HE morphology and immunohistochemistry and 124 cases (94.6%) could be categorized by the above routine methods plus gene rearrangement (P<0.05). No clonal IgH and TCR-γ gene rearrangement was detected in 6 cases of Castlemans disease and 3 angioimmunoblastic lymphadnopathy. Gene rearrangement was not consistent with morphology and immunohistochemistry in 7 cases of the lymphomas. Conclusions Considerate combined application of IgH and TCR-γ gene rearrangement with HE morphology and IHC could efficiently improve the accurate diagnosis of NHL.

关 键 词：免疫组化 Γ基因重排 NHL 分型诊断 TCR 非霍奇金淋巴瘤 阳性 结论 显著性 目的 

分 类 号：R733[医药卫生—肿瘤] R392[医药卫生—临床医学]