Wan J H, Sykes P J, Orell S R, Morley A A
Department of Haematology, Flinders Medical Centre, Bedford Park, South Australia.
J Clin Pathol. 1992 May;45(5):420-3. doi: 10.1136/jcp.45.5.420.
To use the polymerase chain reaction to detect monoclonality at the immunoglobulin heavy chain gene locus in cells derived from lymph node aspirates.
A nested two-stage polymerase chain reaction (PCR) for the VDJ region of the immunoglobulin heavy chain gene was used to detect monoclonality. The total number of cells available for diagnosis by PCR in lymph node aspirates was between 10(4) and 10(5).
A monoclonal band was detected in 21 of 25 malignant B-lymphomas. The other four specimens gave polyclonal bands. Specimens from reactive lymph nodes produced polyclonal bands in 14 cases, no product in two cases, and one specimen gave two monoclonal bands. Polyclonal bands were obtained for three Hodgkin's lymphoma samples and five metastatic carcinomas. Four metastatic carcinoma samples gave no amplification.
Detection of monoclonality in a cell population is strongly suggestive of malignant disease. The simple PCR method presented here should complement conventional cytological and immunological methods for diagnosis of malignancy by lymph node aspirates.
利用聚合酶链反应检测淋巴结穿刺液来源细胞免疫球蛋白重链基因位点的单克隆性。
采用针对免疫球蛋白重链基因VDJ区域的巢式两步聚合酶链反应（PCR）检测单克隆性。淋巴结穿刺液中可用于PCR诊断的细胞总数在10⁴至10⁵之间。
25例恶性B淋巴瘤中有21例检测到单克隆条带。其他4份标本出现多克隆条带。反应性淋巴结标本14例产生多克隆条带，2例无产物，1份标本出现两条单克隆条带。3份霍奇金淋巴瘤样本和5份转移性癌样本获得多克隆条带。4份转移性癌样本未出现扩增。
细胞群体中单克隆性的检测强烈提示恶性疾病。本文介绍的简单PCR方法应补充传统细胞学和免疫学方法用于通过淋巴结穿刺液诊断恶性肿瘤。
