Nishiuchi R, Yoshino T, Teramoto N, Sakuma I, Hayashi K, Nakamura S, Seino Y, Akagi T
Department of Pediatrics, Okayama University Medical School, Japan.
Cancer. 1996 Feb 15;77(4):757-62.
Little is known about the clonal heterogeneity of non-Hodgkin's lymphoma between presentation and relapse, although several such reports have been published on acute lymphoblastic leukemia.
We examined five patients with B-cell lymphoma who relapsed more than 5 years after initial presentation. Formalin fixed, paraffin embedded tissues were analyzed for clonal immunoglobulin heavy chain gene rearrangement by the polymerase chain reaction (PCR) and sequencing of the PCR products. Four specimens retained the original histologic type, but one showed histologic transformation from diffuse large cell lymphoma to follicular small cleaved cell lymphoma.
Although the size of the PCR products looked identical on the gel between presentation and relapse in all patients, only three of the four specimens that retained the original type had identical gene rearrangements at both presentation and relapse. One of these four and the fifth specimen showed novel gene rearrangements.
This study suggests that late relapse lymphoma may present as a new clone. Sequencing of the PCR products is important in the evaluation of clonal heterogeneity.
尽管已有多篇关于急性淋巴细胞白血病的此类报道，但对于非霍奇金淋巴瘤初诊与复发之间的克隆异质性却知之甚少。
我们研究了5例初次就诊5年多后复发的B细胞淋巴瘤患者。采用聚合酶链反应（PCR）及PCR产物测序法，对福尔马林固定、石蜡包埋组织进行克隆性免疫球蛋白重链基因重排分析。4个标本保留了原来的组织学类型，但1个标本显示从弥漫性大细胞淋巴瘤转变为滤泡性小裂细胞淋巴瘤。
尽管所有患者初诊与复发时PCR产物在凝胶上的大小看起来相同，但保留原来类型的4个标本中只有3个在初诊和复发时具有相同的基因重排。这4个标本中的1个以及第5个标本显示出新的基因重排。
本研究提示晚期复发淋巴瘤可能表现为一个新的克隆。PCR产物测序在评估克隆异质性方面很重要。
