BIOMED-2标准化基因重排检测在非霍奇金淋巴瘤诊断中的意义

发布时间：2018-02-05 03:18

本文关键词： 非霍奇金淋巴瘤 BIOMED-标准化基因重排 PCR片段分析 Ig/TCR基因重排　出处：《中国实验血液学杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:利用BIOMED-2标准化免疫球蛋白(Ig)/T细胞受体(TCR)基因重排检测非霍奇金淋巴瘤(NHL)患者骨髓Ig或TCR基因重排,探讨Ig/TCR基因重排在非霍奇金淋巴瘤诊断中的应用意义。方法:从骨髓及石蜡包埋组织(FFPE)标本中提取基因组DNA,采用BIOMED-2系统引物,进行多重PCR扩增并利用PCR片段分析法进行Ig/TCR基因重排的克隆性分析。结果:在235例T细胞非霍奇金淋巴瘤(T-NHL)中,TCRγ和TCRx单克隆重排阳性率分别为57.9%和50.2%,TCRγ和TCRβ的联合检出率为71.9%。在583例B细胞非霍奇金淋巴瘤(BNHL)IgH和IgK单克隆重排阳性率分别为70.7%和69.3%,IgH和IgK的联合检出率为81.6%。套细胞淋巴瘤与滤泡淋巴瘤、弥漫大B细胞淋巴瘤IgH(84.8%对34.0%(P0.001);84.8%对9.2%(P=0.025)和IgK(75.8%vs 50.9%,P0.001;75.8%vs 16.1%(P0.001)重排阳性率差异具有统计学意义。Ig基因重排阳性BNHL患者中,65例(13.7%)患者存在TCR重排阳性。TCR重排阳性T-NHL患者中,未见Ig基因重排阳性。30例弥漫大B细胞淋巴瘤患者FFPE标本有25例(83.3%)检出Ig基因重排,与骨髓标本重排检出率相比较,差异具有统计学意义(P0.001)。结论:利用BIOMED-2标准化Ig/TCR基因重排检测对于淋巴瘤的诊断有辅助性作用,并且利用序列分析法可提高重排检测的敏感性和特异性,对于淋巴瘤的早期诊断有很高的价值。
[Abstract]:Objective: using the BIOMED-2 standard immunoglobulin (Ig) /T cell receptor (TCR) gene rearrangement detection of non Hodgkin's lymphoma (NHL) in bone marrow of patients with Ig or TCR gene rearrangement, explore the application significance of Ig/TCR gene rearrangement in diagnosis of non Hodgkin lymphoma. Methods: paraffin embedded tissues from bone marrow and paraffin (FFPE) genomic DNA samples, using BIOMED-2 primers, analysis of multiple PCR amplification and Cloning Analysis of Ig/TCR gene rearrangement by PCR fragments. Results: in 235 cases of T cell non Hodgkin's lymphoma (T-NHL), TCR gamma and TCRx rearrangement positive rates were 57.9% and 50.2%, TCR and TCR combined detection of beta gamma rate of 71.9%. in 583 cases of B cell non Hodgkin's lymphoma (BNHL) IgH and IgK rearrangement positive rates were 70.7% and 69.3%, IgH and IgK combined detection rate of 81.6%. cell lymphoma and follicular lymphoma, diffuse large B cell (84.8% to 34% IgH lymphoma (P0.001); 84.8% to 9.2% (P=0.025) and IgK (75.8%vs 50.9%, P0.001 16.1%; 75.8%vs (P0.001) was statistically significant difference between the positive rate of rearrangement of.Ig gene rearrangement in patients with BNHL, 65 cases (13.7%) TCR rearrangement.TCR rearrangement in T-NHL patients with no Ig gene rearrangement.30 cases of diffuse large B cell lymphoma specimens of 25 cases of FFPE patients (83.3%) detection of Ig gene rearrangement rate compared with bone marrow specimens rearrangement detection, the difference was statistically significant (P0.001). Conclusion: the detection of Ig/TCR gene rearrangement by BIOMED-2 standard has a supplementary role for the diagnosis of lymphoma, and using sequence analysis method rearrangement can improve the sensitivity and specificity for early diagnosis of lymphoma with high value.

【作者单位】：中国医学科学院北京协和医学院血液病医院(血液学研究所)病理中心;天津市天津医院检验科;
【基金】：国家自然科学基金(81400175)
【分类号】：R733.1
【正文快照】： 非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)是目前最常见的原发于淋巴组织的恶性肿瘤之一,存在病理形态、免疫表型、临床特征的高度异质性。NHL的组织学形态多样,形态学结合免疫组化能确诊70%~80%的病例,其余20%?30%常与反应性病变难以区别。免疫球蛋白(immun0globulin,每)

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