Tong Yi, Qiao Chun, Wu Ruo-Qi, Liu Peng, Zhou Xin
Department of Hematology, Jiangsu Provincial Hospital, Nanjing, Jiagnsu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011 Dec;19(6):1409-14.
This study was purposed to explore the feasibility of BIOMED-2 protocols for detection of immunoglobin (IG) and T-cell receptor (TCR) gene clonal rearrangement in bone marrow of Non-Hodgkin's lymphoma(NHL) patients, and to evaluate its clinical value. Gene clonal rearrangment (IGH, IGK, IGL, TCRβ, TCRγ, TCRδ) was detected by using BIOMED-2 protocols in 73 bone marrow examples of NHL patients. The PCR results were compared with the cytomorphologic examination of bone marrow. The correlation between PCR detection results and clinical stage, pathological factors were also evaluated. The results showed that clonal IG or TCR gene rearrangements were found in 31 of 73 cases (42.5%), higher than the positive rate of cytological analysis (24.7%, 18/73, p < 0.05). IG/TCR clonality rates were 40.0% (22/55) for B-NHL and 50% (9/18) for T-NHL. IG/TCR clonality rates detected in patients with III/IV stage were higher than those with I/II stage (p < 0.05). It is concluded that BIOMED-2 protocols are effective methods for detection of abnormalities in bone marrow in patients with lymphoma, and are superior to cytomorphologic examination. The positive rate of PCR detection is correlated with Ann Arbor stage, but is not related with malignant degree, age, treatment status, B symptoms or the involvement of spleen.
本研究旨在探讨BIOMED-2方案检测非霍奇金淋巴瘤（NHL）患者骨髓中免疫球蛋白（IG）和T细胞受体（TCR）基因克隆重排的可行性，并评估其临床价值。采用BIOMED-2方案检测73例NHL患者骨髓标本中的基因克隆重排（IGH、IGK、IGL、TCRβ、TCRγ、TCRδ）。将PCR结果与骨髓细胞形态学检查结果进行比较。同时评估PCR检测结果与临床分期、病理因素之间的相关性。结果显示，73例中有31例（42.5%）检测到克隆性IG或TCR基因重排，高于细胞学分析的阳性率（24.7%，18/73，p<0.05）。B-NHL的IG/TCR克隆率为40.0%（22/55），T-NHL为50%（9/18）。III/IV期患者的IG/TCR克隆率高于I/II期患者（p<0.05）。结论：BIOMED-2方案是检测淋巴瘤患者骨髓异常的有效方法，优于细胞形态学检查。PCR检测阳性率与Ann Arbor分期相关，但与恶性程度、年龄、治疗状态、B症状或脾脏受累情况无关。
