Department of Pathology, College of Basic Medicine, Chongqing Medical University, Chongqing, China.
Department of Internal Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Pathol Res Pract. 2019 Nov;215(11):152615. doi: 10.1016/j.prp.2019.152615. Epub 2019 Aug 29.
To explore the clinical value of immunoglobulin (Ig) and T cell receptor (TCR) gene rearrangement in the diagnosis of non-Hodgkin lymphoma.
Using the standardized BIOMED-2 multiplex PCR strategy to detect IgH, IgK and TCR in 272 cases of mature B-cell lymphoma, 55 cases of mature T-cell lymphoma, 21 cases of extranodal NK/ T-cell lymphoma, nasal type, and 20 cases of lymphoid tissue reactive hyperplasia.
Among all mature B-cell lymphomas, the sensitivity of Ig gene rearrangement was 91.18% (248/272), IgH and IgK gene rearrangement was 76.47% (208/272) and 75.00% (204/272), respectively, meanwhile the sensitivity of TCRγ rearrangement was 3.68% (10/272). In the 55 cases of mature T-cell lymphoma, the sensitivity of the detection of TCRγ was 76.36% (44/55), at the same time the sensitivity of Ig gene rearrangement was 14.55% (8/55), IgH and IgK gene rearrangement was 7.27% (4/55) and 12.73% (7/55), respectively. In 21 cases of extranodal NK/T cell lymphoma, nasal type, and 20 cases of reactive lymphoid hyperplasia, no gene rearrangement was found in the samples of IgH, IgK and TCR. The sensitivity of gene rearrangement in Ig/TCR in B and T-cell lymphoma was significantly different from that in the control group (P < 0.05).
The Ig/TCR gene rearrangement of BIOMED-2 multiplex PCR strategy has important auxiliary value in the diagnosis of B/T-cell non-Hodgkin lymphoma respectively, however, a few B-cell lymphomas may company TCR gene rearrangement as well as a few T-cell lymphomas may accompany Ig gene rearrangement, it must be comprehensively judged with the combination of morphology, immunohistochemistry and clinical features.
探讨免疫球蛋白(Ig)和 T 细胞受体(TCR)基因重排在非霍奇金淋巴瘤诊断中的临床价值。
采用标准化 BIOMED-2 多重 PCR 策略,检测 272 例成熟 B 细胞淋巴瘤、55 例成熟 T 细胞淋巴瘤、21 例结外 NK/T 细胞淋巴瘤、鼻型和 20 例淋巴组织反应性增生中的 IgH、IgK 和 TCR。
在所有成熟 B 细胞淋巴瘤中,Ig 基因重排的敏感性为 91.18%(248/272),IgH 和 IgK 基因重排的敏感性分别为 76.47%(208/272)和 75.00%(204/272),同时 TCRγ 基因重排的敏感性为 3.68%(10/272)。在 55 例成熟 T 细胞淋巴瘤中,TCRγ 检测的敏感性为 76.36%(44/55),同时 Ig 基因重排的敏感性为 14.55%(8/55),IgH 和 IgK 基因重排的敏感性分别为 7.27%(4/55)和 12.73%(7/55)。在 21 例结外 NK/T 细胞淋巴瘤、鼻型和 20 例反应性淋巴组织增生中,均未发现 IgH、IgK 和 TCR 基因重排。B 和 T 细胞淋巴瘤中 Ig/TCR 基因重排在基因重排中的敏感性明显不同(P<0.05)。
BIOMED-2 多重 PCR 策略的 Ig/TCR 基因重排分别对 B/T 细胞非霍奇金淋巴瘤的诊断具有重要的辅助价值,但少数 B 细胞淋巴瘤可能伴有 TCR 基因重排,少数 T 细胞淋巴瘤可能伴有 Ig 基因重排,必须结合形态学、免疫组织化学和临床特征进行综合判断。