IgH基因重排在B淋巴瘤微小残留病中的应用

目的探讨IgH基因重排在B细胞淋巴瘤临床诊治中的应用.方法应用半巢式PCR技术对IgH基因的CDRⅡ区和CDRⅢ区进行基因重排检测.共检测45例骨髓标本.其中正常标本8例,淋巴瘤标本37例(B细胞淋巴瘤27例,T细胞淋巴瘤10例).结果 8例正常标本未检测到FR2A或FR3A的重排;27例B细胞淋巴瘤中,23例(85.2%)可检测到FR2A或FR3A重排,其中FR2A重排16例(59.3%),FR3A重排20例(74.1%),FR2A、FR3A均有重排者13例(48.1%);10例T淋巴瘤中FR2A重排1例,FR3A重排3例.骨髓穿刺检查:27例B淋巴瘤中5例原幼淋细胞>5%,FR2A和FR3A阳性各4例;22例原幼淋细胞<5%者,FR2A阳性12例,FR3A阳性16例.结论单克隆性IgH重排对鉴别淋巴系统肿瘤及检测骨髓中的微小残留病变有一定参考价值.

Study of IgH rearrangement in detecting minimal residual disease of non-hodgkin lymphoma

Objective To assess the significance of detecting clonal rearrangement of immunoglobulin H gene by PCR in the diagnosis and treatment of malignant lymphoma.Methods 45 bone marrow samples of the patients with malignant lymphoma were investigated by PCR based on amplification of immunoglobulin heavy chain gene using framework 2 (FR2A) and framework 3 (FR3A) region primer.Results The rearrangement of FR2A or FR3A were not detected in 8 normal cases.Among 27 cases with B cell lymphoma,16/27(59.3%) and 20/27(74.1%) cases showed monoclonality with FR2A primer and FR3A primer respectively.Among 10 cases with T cell lymphoma,1/10 and 3/10 cases showed monoclonality with FR2A primer and FR3A primer respectively.Bone marrow examinations showed lymphoblast of 5 samples with B cell lymphoma was more than 5%,in which 4/5 cases showed monoclonality with FR2A primer and FR3A primer respectively;22 samples with B cell lymphoma was less than 5%,in which 12/22 and 16/22 cases showed monoclonality with FR2A primer and FR3A primer respectively.Conclusions Detection of IgH gene rearrangement by PCR is of value in the diagnosis of minimal residual disease (MRD) of non Hodgkin lymphoma(NHL).