PCR-SSCP检测非霍奇金淋巴瘤患者骨髓克隆性T细胞受体基因重排及其临床意义  

Determination of Clonal T Cell Receptor Gene Rearrangement in Non-Hodgkin's Lymphoma Patients and Its Clinical Significance

作　　者：徐兵[1] 田红[1] 周淑芸[1] 

机构地区：[1]第一军医大学南方医院血液科,广东广州510515

出　　处：《癌症》2003年第4期397-400,共4页Chinese Journal of Cancer

基　　金：广东省科技攻关项目(99M04911G);广东省医学科研基金项目(A2000375)

摘　　要：背景与目的:进一步了解非霍奇金淋巴瘤(non-Hodgkinslymphoma,NHL)患者骨髓标本克隆T细胞受体(Tcellreceptor,TCR)基因重排情况及临床意义。方法:应用聚合酶链反应(polymerasechainreaction,PCR)联合单链构象多态性(single-strandconformationpolymorphism,SSCP)分析43例NHL患者骨髓标本TCRVγI-Jγ基因重排情况。结果:43例NHL患者有26例(60.5%)存在克隆性TCRVγI-Jγ基因重排。16例骨髓形态学检查未发现淋巴瘤细胞浸润者中有3例(18.8%)发现克隆性TCRVγI-Jγ基因重排,此3例患者分别于4～9个月后行骨髓形态检查时发现淋巴瘤细胞浸润;27例骨髓形态学检查有淋巴瘤细胞浸润者有23例(85.2%)存在克隆性TCRVγI-Jγ基因重排阳性。26例PCR扩增阳性病例经SSCP分析发现7例(26.9%)存在寡/亚克隆重排。7例存在寡/亚克隆重排患者经3～11个月有5例(71.4%)发展为白血病,存在寡/亚克隆重排NHL患者1年内转化为白血病的发生率显著高于无寡/亚克隆重排患者(10.5%)(P<0.005)。结论:应用PCR检测NHL患者骨髓标本克隆性TCRVγI-Jγ基因重排可较骨髓形态学检查更早发现NHL患者骨髓浸润微小病灶。具有寡/亚克隆NHL患者更易发展为白血病,还可发展为急性非淋巴细胞白血病。BACKGROUND ＆OBJECTIVE: The aim of this study was to investigate the clonal T cell receptor (TCR) gene rearrangement in the patients with non Hodgkins lymphoma (NHL) and its clinical significance. METHODS: TCRVγI Jγ〓gene rearrangement were detected in 43 patients with polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP). RESULTS: Of 43 cases of NHL, 26 (60.5％) were found with clonal TCRVγI Jγ〓gene rearrangement. Among 16 cases without bone marrow morphologic involvement,3 cases (18 8％) were found with clonal TCRVγI Jγ〓gene rearrangement. These 3 cases presented bone marrow morphologic involvement 4 9 months later.Clonal TCRVγI Jγ〓gene rearrangement were detected in 85.2％(23/27) cases with bone marrow morphologic involvement. Among 26 cases with clonal TCRVγI Jγ〓gene rearrangement, 7 cases (26 9％) was found with oligoclonal/subclonal rearrangement after PCR SSCP analysis. Of 7 cases with oligoclonal/subclonal rearrangement, 5 (71 4％) developed to leukemia 3 11 months later. The number of NHL patients with oligoclonal/subclonal rearrangement developed to leukemia was significantly higher than that (10 5％) of NHL patients without oligoclonal/subclonal rearrangement (P< 0 005) within 1 year. CONCLUSION: The detection of clonal TCRVγI Jγgene rearrangement by PCR methods can be used to find bone marrow minimal disease in NHL patients without morphologic abnormality. NHL patients with oligoclonal/subclonal rearrangement are more likely to develop to leukemia; it can also develop to acute nonlymphoblastic leukemia. Further investigation was needed in this respect.

关 键 词：非霍奇金淋巴瘤 T细胞受体基因重排 寡克隆 亚克隆 聚合酶链反应 单链构象多态性 

分 类 号：R733.1[医药卫生—肿瘤]