多重引物聚合酶链反应扩增丙型肝炎病毒基因及基 …

利用聚合酶链反应（ＰＣＲ）技术对丙型肝炎病毒（ＨＣＶ）的５’－非编码区（５’－ＮＣＲ）、Ｃ及ＮＳ４基因区的３对引物分别及同时扩增，检测８０例抗－ＨＣＶ阳性患者的血清ＨＣＶ ＲＮＡ，并进行了ＨＣＶ基因分型研究。各不同引物所介导的ＰＣＲ检出ＨＣＶ ＲＮＡ的结果为：５’－ＮＣＲ基因区６０％（４８／８０），Ｃ基因区３７％（３０／８０），ＮＳ４基因区３０％（２４／８０）。以上３对引物同时扩增仅４２％（３４／     

多聚酶链反应技术在NHL基因诊断中的应用研究

收集非何杰金淋巴瘤（ＮＨＬ）标本５９例。用全Ｔ（ＵＣＨＬ一１）与全Ｂ（Ｌ２６）ＭｃＡｂ作免疫组化分型。然后应用ｌｇＨ单轮和半重叠基因引物，Ｔ细胞受体β（ＴＣＲ＿β）基因引物进行多聚酶链反应（ＰＣＲ）扩增检测克隆性基因重排。检测阳性结果：新鲜组织ｌｇＨ７１．４％（１０．／１４），ＴＣＲ＿β８３．３％（１０／１２）。石蜡包埋组织ＩｇＨ（半重叠扩增）８０％（１２／１５），ＴＣＲ＿β７３．３％（１１／１５）。无假阳性。其中有６例有争议的疑难病例明确了诊断。结果表明ＰＣＲ技术是当前最特异、敏感而快速的ＮＨＬ克隆性基因重排检测方法。     

T细胞受体Vβ基因在识别HSV—2过程中的表达水平和特点

本课题主要研究Ｔ细胞受体（ＴＣＲ）识别抗原后Ｖβ基因发生重排，ｍＲＮＡ表达水平改变。用紫外线处理的单纯疱疹病毒－２型（ＨＳＶ－２）、ＨＳＶ－２及ＰＨＡ分别感染或刺激正常人的ＰＢＬｓ，培养４～６天后，提取ｍＲＮＡ，并采用ＲＴ－ＰＣＲ、Ｓｏｕｔｈｅｒｎ杂交发现识别ＨＳＶ－２的ＴＣＲＶβ２、６、７、８基因在体外选择性扩增。在采用ＨＳＶ－２攻击皮肤病患者发作期、缓解期以及再发作期的ＰＢＬｓ时，发现ＴＣＲＶβ基因表达随着病程变化而改变，尤其Ｖβ７亚家族表达水平显著高于其它亚家族基因，这显示了ＴＣＲＶβ基因的变化是恒定特异性的。     

多重PCR检测急性非淋巴细胞白血病IgH及TCRVγI—Jγ基因重排

目的：为进一步了解急性非淋巴细胞白血病病人基因重排情况。方法：应用多重ＰＣＲ技术检测４１例ＡＮＬＬ病人ＩｇＨ及ＴＣＲＶγＩ－Ｊγ基因重排。结果：２６．８％（１１／４１）ＡＮＬＬ病人存在ＩｇＨ或／和ＴＣＲＶγＩ－Ｊγ基因重排,３例病人同时存在ＩｇＨ和ＴＣＲＶγＩ－Ｊγ基因重排;基因重排阳性ＡＮＬＬ治疗缓解率低于重排阴性ＡＮＬＬ病人。     

应用T细胞受体家族特异性引物的PCR方法对T细胞…

应用ＰＣＲ方法对１２例血管免疫母细胞淋巴结病样Ｔ细胞淋巴瘤（ＡＩＬＤ－ＴＣＬ）进行Ｔ细胞受体γ链（ＴＣＲγ）基因重排分析，结果显示：１２例均有单克隆型的ＴＣＲγ基因重排；而正常人周围血淋巴细胞及非典型性淋巴增生性病变则为多克隆型重排。实验证实ＡＩＬＤ－ＴＣＬ为来自Ｔ细胞的单克隆性肿瘤性疾病。用家族特异性ＴＣＲγ引物对石蜡包埋组织行ＤＮＡ扩增是检测Ｔ细胞性的克隆性增生的敏感，方便，快速的方法，优于传     

原发性脑内淋巴瘤临床病理、免疫组化、基因重排分析

目的：研究脑内原发性恶性淋巴瘤临床病理、免疫且化及免疫性基因重排特征。方法：对６例脑原发性恶性淋巴瘤作了临床病理形态观察和免疫组化分析（Ｓ－Ｐ法）,并用ＰＣＲ技术单轮及半巢式扩增法进行了ＩｇＨ及ＴＣＲ－β基因重排检测。结果：６例皆为非霍奇金Ｂ细胞淋巴瘤。瘤细胞大部分是中心或中心母细胞型,常伴浆样分化,往往围绕血管排列。ＰＣＲ克隆性基因重排,ＩｇＨ单轮法（２／６例）阳性,半巢式（６／６例）阳性,ＴＣ     

SLE病人外周血Bcl—2／JH基因重排检测的意义

应用聚合酶链反应（ＰＣＲ）方法检测３１例ＳＬＥ病人外周血单个核细胞（ＰＢＭＣ）Ｂｃｌ－２／ＪＨ基因重排现象和流式细胞仪间接双标记法分析其Ｔ（ＣＤ３）、Ｂ（ＣＤ１９）细胞Ｂｃｌ－２蛋白的表达。结果显示，ＳＬＥ病人Ｔ细胞Ｂｃｌ－２蛋白表达明显高于正常人（４２．９５％±２８．４７％对比９．９４％±４．９６％，Ｐ＝０．０００４），尤其以活动期ＳＬＥ病人为明显，而Ｂ细胞Ｂｃｌ－２蛋白表达与正常人之间并无统计学差异（７９．２１％±１０．６９％对比８１．９６％±６．９７％；Ｐ＝０．４６０２）。７例ＳＬＥ病人具有典型的Ｂｃｌ－２／ＪＨ基因重排（占２２．５８％），且均为ＳＬＥ活动期病人，其Ｔ细胞Ｂｃｌ－２蛋白表达明显高于无基因重排的ＳＬＥ病人，其Ｂ细胞Ｂｃｌ－２表达并无差异（Ｐ＞０．３９０５）。说明Ｂｃｌ－２／ＪＨ基因重排现象可见于ＳＬＥ，并与Ｔ细胞Ｂｃｌ－２蛋白高表达有关，表明细胞凋亡抑制基因Ｂｃｌ－２在ＳＬＥ发病机制中具有重要作用。     

鼠抗hTNF—α单克隆抗体重链基因片段的克隆和cDNA序列测定

采用反转录ＰＣＲ方法，以一对锚ＰＣＲ引物和一对针对鼠ＩｇＶＨ区基因的引物，从分泌鼠抗ｈＴＮＦ－α单克隆抗体的Ｅ６杂交瘤细胞株中，分别扩增和克隆了自５′非翻译区至Ｃγ１近３′端的重链基因片段和重链可变区基因片段，并测定了其核苷酸序列。计算机分析表明，系重排的鼠Ｉｇ重链基因。     

应用T细胞受体家族特异性引物的PCR方法对T细胞性淋巴瘤的研究

应用ＰＣＲ方法对１２例血管免疫母细胞性淋巴结病样Ｔ细胞性淋巴瘤（ＡＩＬＤ一ＴＣＬ）进行Ｔ细胞受体γ链（ＴＣＲ＿γ）基因重排分析，结果显示：１２例均有单克隆型的ＴＣＲγ基因重排；而正常人周围血淋巴细胞及非典型性淋巴增生性病变则为多克隆型重排。实验证实ＡＩＬＤ一ＴＣＬ为来自Ｔ细胞的单克隆性肿瘤性疾病。用家族特异性ＴＣＲγ引物对石蜡包埋组织行ＤＮＡ扩增是检测Ｔ细胞性的克隆性增生的敏感、方便、快速的方法，优于传统的Ｓｏｕｔｈｅｒｎ印迹杂交方法，有一定的实用意义。     

PCR技术检测IgH和TCRγ基因重排及其在淋巴瘤诊断中的初步应用

应用半重叠ＰＣＲ扩增ＩｇＨ、混合引物ＰＣＲ增ＴＣＲγ基因重排片段，并初步用于淋巴瘤的诊断，发现７７％的Ｂ细胞性非何杰金淋巴瘤出现ＩｇＨ基因重排的单克隆条带，９１％的Ｔ细胞性非何杰金淋巴瘤出现ＴＣＲγ基因重排条带。提示ＰＲＣ对鉴定淋巴细胞增生的克隆性和细胞源性具有重要价值。与Ｓｏｕｔｈｅｒｎ印迹杂交相比，ＰＣＲ具有简便，快速等特点，更具有临床实用性。     

Hodgkin病单个H/R-S细胞Ig基因重排的研究

目的 探讨Ｈｏｄｇｋｉｎ病（ＨＤ）Ｈｏｄｇｋｉｎ／Ｒｅｅｄ－Ｓｔｅｒｎｂｅｒｇ（Ｈ／Ｒ－Ｓ）。方法 从８例ＨＤ溶冻切片上共提取Ｈ／Ｒ－Ｓ细胞６８个,用ＩｇＨ通用引物ＦＲⅢａ／ＪＨ和κ、λ轻链家族性特性性引物行ＰＣＲ检测。结果 １例淋巴细胞为主型（ＬＰ）ＨＤ的Ｈ／Ｒ－Ｓ细胞重复出现ＩｇＨ和Ｖκ家族重排;２例结节硬化型ＨＤ（ＮＳＨＤ）中,１例Ｈ／Ｒ－Ｓ细胞有单次的ＩｇＨ、Ｖκ４和Ｖλ３重排;１列有重复     

Hodgkin's disease: immunoglobulin heavy and light chain gene rearrangements revealed in single Hodgkin/Reed-Sternberg cells.

AIM: To corroborate and investigate the nature of Hodgkin/Reed-Sternberg cells (H/R-S) of various subtypes of Hodgkin's disease. METHOD: Single H/R-S cells were micro-picked from frozen sections of tissues affected by Hodgkin's disease. The DNA from these cells was amplified by the polymerase chain reaction (PCR) with immunoglobulin heavy chain (IgH) gene FRIIIa/JH primers and light chain gene family specific primers. RESULTS: Fifty two of 135 isolated cells gave specific reaction products (36%). IgH and V kappa 4 gene rearrangements were found repeatedly in many H/R-S cells from one case of lymphocyte predominant Hodgkin's disease. Repeated V kappa 4 and individual IgH/V kappa 4,2 rearrangements were seen in one case, and individual IgH and V lambda 3/V kappa 4 rearrangements were seen in another case of nodular sclerosis-type Hodgkin's disease. Repeated IgH/V lambda 3 and individual V lambda 2,4 rearrangements, repeated V kappa 4 and individual IgH/V kappa 3 rearrangements, and repeated IgH and individual V kappa 3/V kappa 4 rearrangement were detected, respectively, in three cases of mixed cellularity-type Hodgkin's disease. Repeated and individual IgH rearrangements were found in another two cases of mixed cellularity-type Hodgkin's disease. CONCLUSION: The H/R-S cells isolated from lymphocyte predominant Hodgkin's disease had IgH and V kappa 4 gene rearrangements, which supports the conclusion that this disease results from a proliferation of neoplastic B cells. The IgH and kappa and/or lambda gene rearrangements seen in H/R-S cells isolated from classic Hodgkin's disease (mixed cellularity-type and nodular sclerosis-type) support the theory that these cells derive from B lineage cells at various stages of differentiation. To our knowledge, this is first time that lambda gene rearrangements have been detected in H/R-S cells.     

The polymerase chain reaction in the demonstration of monoclonality in T cell lymphomas.

AIMS--To evaluate polymerase chain reaction (PCR) amplification of T cell receptor (TCR) beta and gamma chain genes as a means of demonstrating monoclonality in T cell lymphomas using histological samples; to compare the performance of PCR with Southern blot analysis. METHODS--TCR-beta, TCR-gamma and immunoglobulin heavy chain (IGH) genes were analysed using PCR in 55 cases of T cell lymphoma (28 frozen tissue and 27 paraffin wax embedded samples), diagnosed using morphological and immunohistochemical criteria. The 28 frozen samples were subjected to Southern blot analysis using TCR-beta, TCR-gamma and IGH gene probes. Twenty five B cell lymphomas and 21 non-neoplastic lymphoid tissue samples were used as controls. RESULTS--Using TCR-beta PCR, monoclonality was detected in 24 (44%) of 55 T cell lymphomas compared with 43 (78%) of 55 using TCR-gamma PCR and in 82% with both techniques. Five (9%) of 55 T cell lymphomas were IGH PCR positive. None of the non-neoplastic lymphoid control samples were PCR positive. All B cell lymphomas showed a polyclonal pattern with TCR-beta PCR while a single B cell lymphoma was positive using TCR-gamma primers. With TCR-beta PCR, a monoclonal result was seen in 12 (43%) of 28 frozen samples of T cell lymphoma, compared with 23 (82%) of 28 using Southern blot analysis. With TCR-gamma PCR, 19 (68%) of 28 frozen tissue samples were positive, compared with 26 (93%) of 28 using Southern blot analysis. A single case showed IGH rearrangement by Southern blot analysis. CONCLUSION--TCR-gamma PCR should be the method of choice for analysis of clonality in paraffin wax embedded sections of lymphoproliferative lesions, as TCR-beta PCR has a high false negative rate. Southern blot analysis remains the most successful technique when sufficient fresh tissue samples and resources are available.     

Detection of clonal T-cell receptor-gamma gene rearrangement by PCR/temporal temperature gradient gel electrophoresis

Limited combinatorial and junctional diversity in TCR-gamma gene rearrangement can result in amplification products that are difficult to interpret when analyzed by conventional gel electrophoresis methods that separate DNA based on size (polymerase chain reaction [PCR]/polyacrylamide gel electrophoresis [PAGE]). We describe a simple approach to the detection of clonal TCR-gamma gene rearrangement using temporal temperature gradient gel electrophoresis (TTGE) that uses a gradual and uniform increase in the temperature of a constant denaturing gel to resolve different DNA molecules based on base pair composition. We tested 42 clinical specimens (30 blood specimens and 12 formalin-fixed paraffin-embedded tissues) for T-cell clonality by PCR/PAGE and PCR/TTGE. Concordant results were obtained in only 22 specimens (52%). Of the 20 discordant cases, 18 samples were positive by TTGE and negative by PAGE. For all of the discordant cases, the TTGE yielded results that correlated better with the clinical data than did the PAGE method. We conclude that PCR/TTGE is more accurate and easier to perform than current methods for detecting clonal populations of T cells.     

Detection of concurrent/recurrent non-Hodgkin's lymphoma in effusions by PCR

A subset of patients with non-Hodgkin's lymphoma (NHL), present with or subsequently develop lymphocytic effusions. Differential diagnosis between reactive lymphocytosis and recurrent low-grade NHL is difficult by cytology alone. We studied the use of polymerase chain reaction (PCR)-based techniques to detect concurrent/recurrent NHL. Both primary tumors and atypical lymphocytic effusions of 12 low-grade B-NHL patients and 4 T-NHL patients were studied. Six pleural effusions (reactive/carcinomatous), in patients with no history of NHL, were included. Samples were amplified by PCR, using Fr3, Fr2, LJH, and VLJH primers specific for the immunoglobulin heavy chain (IgH) gene and Vgamma-8, Vgamma9, Vgamma10, Vgamma11 and Jgamma1/Jgamma2 consensus primers specific for the T-cell receptor gamma (TCR-gamma) gene. IgH gene PCR products were analyzed by polyacrylamide gel electrophoresis (PAGE). TCR-gamma gene PCR products were analyzed using a novel nonradioactive single-strand conformational polymorphism (SSCP) procedure. IgH gene rearrangement analysis demonstrated monoclonality in 11/12 primary low-grade B-NHLs. Identical monoclonal bands were found in both primary tumor and effusion in 9 patients. TCR-gamma gene rearrangement analysis demonstrated monoclonality in 4 of 4 primary T-NHLs. Identical monoclonal banded patterns were found in both primary tumor and effusion in 3 patients. Our results strongly support the diagnosis of concurrent/recurrent NHL in 13 of 16 (81%) cases of atypical lymphocytic effusions. IgH/PAGE and TCR-gamma/SSCP analyses are useful tools in the diagnoses of lymphocytic effusions in patients with NHL.     

Analysis of T cell receptor-gamma gene rearrangements by denaturing gradient gel electrophoresis of GC-clamped polymerase chain reaction products. Correlation with tumor-specific sequences.

We describe a modified denaturing gradient gel electrophoresis (DGGE) procedure with a 40-nucleotide GC clamp in the polymerase chain reaction to improve resolution in amplifying T cell receptor-gamma (TCR-gamma) rearrangements. DNA from 46 cases of lymphoblastic leukemia/lymphoma, 5T cell lines, 2 B cell lines, 7 normal lymphocytes, and 3 cases of Hodgkin's disease was amplified by polymerase chain reaction. In addition, 20 cases of paraffin-embedded T cell lymphomas and 5 cases of reactive hyperplasia were also studied. Clonal TCR-gamma rearrangements were identified on DGGE by the presence of a predominant band. Results obtained from 5 T cell lines and 12 lymphoblastic leukemia/lymphomas containing known TCR-gamma gene rearrangements revealed 100% concordance in detecting clonal rearrangements between DGGE and traditional Southern blot analysis. Of the remaining 34 lymphoblastic leukemia/lymphoma cases studied by DGGE alone, 30 were positive. DGGE analysis of 10 lymphoblastic leukemia/lymphoma cases with known group IV gamma to J gamma 1 or J gamma 2 rearrangement sequences confirmed that the electrophoretic migration was dependent on the tumor-specific rearranged TCR-gamma sequence. In addition, 17 of 20 cases of paraffin-embedded T cell lymphomas were positive by DGGE, 6 of which had the clonal population also identified in fresh tissue DNA. DGGE analysis of GC-clamped polymerase chain reaction products can provide a way to more accurately detect TCR-gamma clonality of lymphoid tumors and can be applied to archival tissues.     

Comparison of in situ hybridisation and polymerase chain reaction in the diagnosis of B cell lymphoma.

AIM: To compare the sensitivity of the detection of immunoglobulin light chain messenger RNA (mRNA) restriction by in situ hybridisation (ISH) and clonal immunoglobulin heavy chain gene rearrangements by polymerase chain reaction (PCR) in the diagnosis of B cell lymphoma. METHODS: Analyses were applied to formalin fixed, paraffin wax embedded, routine diagnostic specimens from cases with a provisional diagnosis of reactive lymph node (n = 23), B cell lymphoma (n = 21), and T cell lymphoma (n = 4). Nonisotopic ISH for kappa and lambda immunoglobulin light chain mRNA was performed using both fluorescein and digoxigenin labelled oligodeoxynucleotide probe cocktails. PCR was carried out on DNA extracted from sections using primers to framework 3 (Fr3) of the V segments and to conserved sequences from the J regions of the immunoglobulin heavy chain genes. RESULTS: All reactive lymph nodes showed a polyclonal pattern of light chain mRNA by ISH, although one showed an excess of kappa positive cells. Nineteen of 21 (90%) cases of B cell lymphoma showed light chain restriction, and a further case showed a vast excess of kappa positive cells. By PCR, 20 of 23 reactive nodes (87%) showed a polyclonal pattern. In 13 of 21 B cell lymphomas (62%) a clonal band was detected. CONCLUSION: In the diagnosis of B cell lymphoma in routinely processed diagnostic material ISH for light chain mRNA was more sensitive (90%) than PCR for heavy chain gene rearrangement using Fr3 and J region primers (62%).     

Peripheral T-cell lymphoma with aberrant expression of CD79a and CD20: a diagnostic pitfall.

Immunohistochemical studies are increasingly used for the routine diagnosis of lymphomas as it is widely accepted that lymphomas of different cell lineages vary in their prognosis and response to therapy. A case of peripheral T-cell lymphoma with aberrant expression of B-cell-associated antigens L-26 (CD20) and mb-1 (CD 79a) is described. The disease pursued an aggressive clinical course, and the patient died of disease 6 weeks after presentation. Immunohistochemical studies demonstrated expression of both T- and B-cell-associated antigens, including CD3, CD8, CD43, TIA-1, CD20, and CD79a. Other markers expressed by the tumor cells included CD56 and S-100. Of interest, betaF-1 staining for the beta chain of T-cell receptor (TCR) complex was positive in the small admixed T lymphocytes but was negative in the tumor cells, raising the possibility of a gamma/delta T-cell lymphoma. Molecular studies by polymerase chain reaction (PCR) demonstrated clonal TCR-gamma chain gene rearrangement without evidence for a clonal rearrangement of the immunoglobulin heavy chain gene. PCR for HHV-8 related sequences was negative. Mb-1 is an IgM-associated protein that was thought to be restricted to normal and neoplastic B cells. Although its coexpression has been reported in up to 10% cases of precursor T-cell lymphoblastic lymphoma, the coexpression of both CD20 and CD79a has not been described in mature T-cell malignancies. Biphenotypic lymphomas associated with HHV-8 have been reported in immunodeficiency, but no evidence of immune deficiency was identified, and studies for EBV and HHV-8 were negative. This case illustrates that no marker has absolute lineage specificity and that immunophenotypic studies should always be performed with panels of monoclonal antibodies. Moreover, cases with ambiguous phenotypes may require genotypic studies for precise lineage assignment.     

Presence of restricted killer immunoglobulin-like receptor repertoire and monoclonal T-cell receptor gamma rearrangement as evidence of mixed NK/T-cell differentiation in a subset of sinonasal lymphomas

Most sinonasal lymphomas have a restricted killer immunoglobulin-like receptor (KIR) repertoire without a monoclonal T-cell receptor-gamma (TCR-gamma) rearrangement, implying an NK lineage. However, the lineage assignment of sinonasal lymphoma with a monoclonal TCR-gamma rearrangement is unclear because of its mixed NK/T phenotype. The possibility of a mixed NK/T lineage arises with the discovery of T cells with NK features, such as KIR(+) T cells or Valpha24(+) NKT cells. The former might transform into a T-cell lymphoma with both a monoclonal TCR-gamma rearrangement and a restricted KIR repertoire; the latter might give rise to a T-cell lymphoma with a monoclonal Valpha24 rearrangement and possibly a restricted KIR repertoire. To identify such mixed-lineage lymphomas, we undertook a survey of 15 consecutive sinonasal lymphomas and found six with both a restricted KIR repertoire and a monoclonal TCR-gamma rearrangement, consistent with KIR(+) T-cell lymphomas. Among these six cases, four female CD56(-)/CD44(-)/CD8(-)/CD45RO(+)/CD45RA(-) cases constituted a distinct group with a better prognosis than the rest of the male cases of sinonasal lymphomas. None of the six cases had a monoclonal Valpha24 repertoire, thus excluding a derivation from NKT cells. The predominance of KIR(+) T cells that normally function in chronic viral infections over Valpha24(+) NKT cells that typically recognize glycolipid antigens is consistent with the known association of Epstein-Barr virus infection with sinonasal lymphoma. The demonstration of mixed lineage in a mature lymphoid neoplasm is unusual and echoes the World Health Organization classification that placed NK-cell and T-cell lymphomas in a mixed group.