血清及血浆标本IgH基因重排对B细胞淋巴瘤患者的诊断价值

目的探讨以血清、血浆为标本,免疫球蛋白重链(IgH)基因重排对B细胞淋巴瘤(BNHL)早期诊断的意义。方法收集病理活检确诊的BNHL患者的血清、血浆,提取肿瘤细胞释放的可溶性DNA。针对IgH基因第三互补决定簇(CDRⅢ)序列,设计引物扩增Fr3和JH区,PCR检测IgH基因重排的比率。结果以BNHL细胞系Raji细胞作为阳性对照,30例确诊的BNHL患者中25例阳性,阳性率83.3%。健康成人及慢性淋巴结炎患者呈阴性结果。IgH基因重排的检出率与患者临床表现、临床分期及肿瘤负荷不具有明显的相关性。结论以血清、血浆为标本,检测IgHCDRⅢ基因重排在临床具有较高的阳性率。标本取材方便,不受淋巴结肿大部位的限制,对BNHL患者的早期诊断具有一定的价值。

The diagnostic significance of Ig heavy chain rearrangement detected in B cell lymphoma patients' serum or plasma blood samples

OBJECTIVE: To evaluate the diagnostic significance of detecting immunoglobulin (Ig) heavy chain (IgH) by using serum or plasma as blood samples. METHODS: First, collect serum and plasma blood samples of patients with B-NHL and extract tumor-derived DNAs. Then design the primer to amplify framework3 (Fr3) from the V segment regions to the J regions of the IgH complementary determining region III (CDR-III) gene. Detect the positive ratio of IgH rearrangement with PCR and evaluate its diagnostic significance. RESULTS: B lymphoma cell line Raji was used as the positive control. Of the 30 B-NHL cases diagnosed with morphologic study, 25 (83.3%) showed IgH rearrangement. DNAs extracted from healthy adults and chronic lymphadenitis patients showed negative result. There was no statistical pertinence between IgH gene rearrangement and clinical manifestation, clinical staging and tumor burden. CONCLUSION: Tumor-derived DNA can be detected in serum or plasma of the majority of patients with B-cell lymphoma. Testing of serum or plasma for tumor associated DNA may be a novel parameter for clinical diagnosis without the restriction of the position of enlarged lymph node.