基因重排检测在原发性鼻腔非霍奇金淋巴瘤诊断和分型中的应用

目的探讨免疫球蛋白重链（immunoglobulin heavy chain, IgH） 和T细胞受体（ non-Hodgkin lymphoma, NHL）基因重排在鼻腔非霍奇金淋巴瘤（polymerse chain reaction, PCR）诊断和分型中的价值。方法采用两对引物进行半巢式聚合酶链反应（polymerse chain reaction，PCR）检测11例B细胞淋巴瘤组织DNA的单克隆性IgH基因重排；采用两对引物进行一步法PCR检测23例NK／T细胞淋巴瘤和20例T细胞淋巴瘤组织DNA的单克隆性TCR基因重排。以10例鼻息肉组织标本作为对照。结果11例B细胞淋巴瘤中IgH基因单克隆性重排10例阳性（90．9％），20例T细胞淋巴瘤中TCR基因单克隆性重排17例阳性（85.0％），23例NK／T细胞淋巴瘤中TCR基因单克隆性重排10例阳性（43.5％）。10例鼻息肉标本采用相应引物扩增结果均为阴性。结论在鼻腔NHL中，基因重排检测是一种有效的辅助诊断和分型方法，采用两对引物进行PCR可提高基因重排检测的阳性率。

Application of detecting gene rearrangement in diagnosing and typing of primary non-Hodgkin''''s lymphoma in nasal cavity

OBJECTIVE: To evaluate the significance of immunoglobulin heavy chain (IgH) gene rearrangement for B-cell lymphoma and T-cell receptor (TCR) gene rearrangement for T-cell lymphoma and NK/T-cell lymphoma in diagnosing and typing of primary non-Hodgkin's lymphoma (NHL) in nasal cavity. METHODS: Semi-nested polymerase chain reaction ( PCR) with two pairs of primers was used to detect monoclonal IgH gene rearrangement in paraffin-embedded tissues from 11 patients with B-cell lymphoma, and one-stepped PCR with two pairs of primers was used to detect T-cell receptor gene rearrangement from 23 patients with NK/T-cell lymphoma and 20 patients with T-cell lymphoma. Ten patients with nasal polyp were detected with all the primers by PCR respectively. RESULTS: Among the 54 patients with an evaluable PCR results, 10 of 11 (90. 9% ) B-cell lymphomas were positive for monoclonal IgH gene rearrangement, 17 of 20 (85. 0% ) T-cell lymphomas and 10 of 23 (43. 5% ) NK/T-cell lymphomas were positive for monoclonal TCR gene rearrangement. Ten patients with nasal polyp were negative for all detection. CONCLUSIONS: Detecting gene rearrangement was an efficient method in auxiliary diagnosing and typing of primary NHL in nasal cavity; Using semi-nested PCR or one-stepped PCR with two pairs of primers can enhance the positive rate of gene rearrangement detection.