The Analysis and Significance of IgH Gene Rearrangement in Non-Hodgkin Lymphoma
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摘要: 目的:探讨免疫球蛋白重链(IgH)基因重排的检测在非霍奇金淋巴瘤(NHL)中的诊断价值。方法:用半巢式和混合聚合酶链式反应方法,联合使用IgHFR3A、FR2A、FR1家族特异性引物Mixtures(VH1、VH2、VH3)检测44例B-NHL患者、1例未分型淋巴瘤、15例T-NHL患者和5例淋巴结反应性增生患者IgH基因克隆性重排情况。结果:1)采用FR3A引物,44例B-NHL有37例出现IgH基因重排,检测率为84%;采用FR2A引物,有27例出现IgH基因重排,检测率为61%;采用FR1家族特异性引物Mixtures(VH1、VH2、VH3)与J区(JHb、JHc)引物,有34、33例出现IgH基因重排,检测率为77%、75%;结合FR3A、FR2A、FR1家族特异性引物Mixtures(VH1、VH2、VH3),总检测率为95%。2)15例T-NHL有4例出现IgH基因重排,而5例LRH未出现IgH基因重排。3)1例免疫组化未分型的NHL经PCR检测后,明确分型为B细胞性淋巴瘤。结论:联合采用多对引物可提高检测阳性率;IgH基因重排检测对鉴别B细胞淋巴瘤和淋巴结反应性增生以及T细胞淋巴瘤有重要意义。Abstract: Objective: To explore the significance for detection of IgH gene rearrangement in diagnosis of non-Hodgkin lymphoma. Methods: The heminested and multiplex polymerase chain reaction (PCR), in combination with family-specific primer mixtures (VH1, VH2, VH3) for IgH FR3A, FR2A, FR1 gene, were used to detect IgH gene cloning rearrangement in 44 patients with B-NHL, 1 with undifferentiated lymphoma, 15 with T-NHL and 5 with lymph node reactive hyperplasia. Results: a) In 44 cases with B-NHL, IgH gene rearrangement was found in 37 and detection rate was 84% using FR3A primer determination; IgH gene rearrangement occurred in 27 with B-NHL and the detection rate was 61% as using FR2A primer determination; IgH gene rearrangement was found in 34 and 33 cases respectively when using the FR1 family specific primer Mixtures (VH1, VH2 and VH3) and J area (JHb, JHc) primer, and the detection rate was 77%, 75% respectively. The combination of FR3A, FR2A and FR1 family specific primers mixture (VH1, VH2 and VH3) was used, with a total detection rate of 95%. b) In 15 cases with T-NHL, IgH gene rearrangement was found in 4 and was not found in 5 with LRH. c) One case with indiscriminate immunohistochemical NHL was defined as B-cell lymphoma after PCR determination. Conclusions: Application of multiple pairs of primers can enhance positive rate of the test and the determination of IgH gene rearrangement will be of important significance for differentiation of B-cell lymphoma and lymph-node reactive hyperplasia, as well as T-cell lymphoma.
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