Ig及TCR克隆性重排在Castleman病诊断中的应用  

Application of immunoglobulin and T-cell receptor gene rearrangementin Castleman’s disease

作　　者：汤涛[1] 吴小延[1] 吴秋良[2] 王芳[1] 

机构地区：[1]中山大学肿瘤防治中心分子诊断科,广东广州510060 [2]中山大学肿瘤防治中心病理科,广东广州510060

出　　处：《解剖学研究》2015年第6期472-474,478,共4页Anatomy Research

摘　　要：目的探讨Castleman病克隆性重排检测及其在鉴别诊断中的应用。方法收集组织病理学确诊的Castleman病38例，利用根据BIOMED一2引物体系设计的IdentiClone系列淋巴瘤基因重排检测试剂盒及Genescanning法进行免疫球蛋白（Ig）和T细胞受体（TCR）基因克隆性重排检测及结果分析。结果38例CD病理组织学分型为透明血管型25例，浆细胞型9例及混合型4例。根据临床病变累及部位为局限型21例，多中心型17例。克隆性分析结果，10例CD克隆性重排阳性，其中6例为Ig克隆性重排，2例为TCR基因重排，2例为Ig和TCR基因双重排。2例MCD为IgH和／或Igk单克隆重排，随访13及21个月后发展为滤泡性淋巴瘤及弥漫大B细胞淋巴瘤。结论大多数cD的淋巴细胞为多克隆性起源，Ig和／或TCR基因发生克隆性重排提示单克隆性增生具有恶性转化趋势和潜能，对推测预后有一定帮助。Objective To investigate the characters of gene rearrangement in Castleman＇ s disease （CD） and determine the clonality status. Methods 38 patients with CD were reviewedfor immunoglobulin （Ig） and T-cell receptor （TCR） gene rearrange- ment analysis using BIOMED-2 and Genescanning analysis. Results Among 38 patients, 25 cases werediagnosed with the hyaline- vascular type, 9 with the plasma cell type and 4 with mixed type. According to clinical features, 21 cases were localized Castleman＇ s disease （LCD） and 17 cases were multicentric Castieman＇ s disease （MCD）. A total of ten were positive for monoclonal rearrangement, among which, 6cases had the clonal rearrangement of the Ig genes, 2 cases had the TCR gene clonal rearrangement （%）, and 2 cases had clonal rearrangements of both Ig and TCR gene. Two cases with clonal rearrangement of Ig gene progressed to follicular lym- phoma and diffuse large B cell lymphoma after following-up with 13-mouths and 21-months, respectively. Conclusion The lymphoid cells in CD are most commonly polyclonal in origin. Rare cases may showlymphocyte monoclonality, which could represent the development of a neoplastic population.

关 键 词：CASTLEMAN病 基因重排 分子遗传学分析 

分 类 号：R733.1[医药卫生—肿瘤]