Slack D N, McCarthy K P, Wiedemann L M, Sloane J P
Department of Histopathology, Royal Marsden Hospital, Sutton, Surrey, U.K.
Diagn Mol Pathol. 1993 Dec;2(4):223-32.
Following our recent reports of detecting clonal immunoglobulin and T-cell receptor gene rearrangements by the polymerase chain reaction, we have improved and simplified the technique for use in diagnostic histopathology laboratories and determined, on coded samples, the sensitivity, specificity, and reproducibility of the modified methodology in distinguishing malignant lymphoma from reactive lymphoid hyperplasia and nonlymphoid tumors. Using only three primer pairs for the immunoglobulin heavy chain and T-cell receptor beta and gamma chain genes on well-characterized lesions of widely varying morphology and immunophenotype, clonal rearrangements were detected in 65% of B-cell lymphomas, and 77-82% of T-cell tumors. Specificity and observer consistency ranged from 93-97%. The method requires very careful control, particularly to avoid misinterpretation of results because of contamination and nonspecific amplification, but in its present form is relatively simple and inexpensive, and gives results on single paraffin-embedded sections within 24 h.
继我们最近报道通过聚合酶链反应检测克隆性免疫球蛋白和T细胞受体基因重排后，我们改进并简化了该技术，使其可用于诊断性组织病理学实验室，并在编码样本上确定了改良方法在区分恶性淋巴瘤与反应性淋巴样增生及非淋巴样肿瘤方面的敏感性、特异性和可重复性。在形态和免疫表型差异很大的典型病变上，仅使用三对针对免疫球蛋白重链、T细胞受体β链和γ链基因的引物，就在65%的B细胞淋巴瘤和77%-82%的T细胞肿瘤中检测到了克隆性重排。特异性和观察者一致性范围为93%-97%。该方法需要非常仔细的控制，尤其是要避免因污染和非特异性扩增而对结果产生错误解读，但就目前形式而言，它相对简单且成本低廉，并且能在24小时内对单张石蜡包埋切片给出结果。
