Abdel-Reheim F A, Edwards E, Arber D A
Department of Pathology, Texas A&M University Health Science Center, College of Medicine, Temple, USA.
Arch Pathol Lab Med. 1996 Apr;120(4):357-63.
To evaluate the utility of a polymerase chain reaction (PCR)-based, B-cell-related molecular panel in the diagnostic workup of hematologic specimens.
DESIGN, SETTING, AND PATIENTS: A PCR panel was applied to 89 specimens from 87 patients, including 55 cases (57 specimens) of known monoclonal B-cell lymphoma, 10 cases of Hodgkin's disease, 2 cases of T-cell lymphoma, and 20 specimens of polyclonal reactive lymphoid tissues. The panel comprised a seminested PCR procedure for immunoglobulin heavy-chain (IgH) gene rearrangement and unnested PCR detection of t(14;18) and t(11;14).
Immunoglobulin heavy-chain was detected in 63%, evidence of t(14;18) in 35%, and evidence of t(11;14) in 3.5% of all the B-cell lymphoma cases. Seventy-seven percent of all cases demonstrated IgH- and/or bcl-2-associated translocations using these primers. The IgH primers alone detected clonality in 82% (28/34) of the nonfollicular lymphomas and 35% (8/23) of the follicular lymphomas, with no false positives in the non-B-cell lymphoma specimens. The addition of two primer sets for the detection of both IgH and bcl-2/JH significantly improved the detection of molecular abnormalities in the follicular lymphoma group from 35% to 70% (16/23). However, no change was noted in the overall detection rate for the nonfollicular lymphoma group. Adding primers for bcl-1/JH did not change the overall detection rate for either group.
Seminested PCR for IgH detected monoclonality in the majority of the nonfollicular lymphomas and is a valuable diagnostic tool in this group. The combination of different primer sets for the detection of IgH gene rearrangement and bcl-2/JH is most desirable for follicular lymphomas.
评估基于聚合酶链反应（PCR）的B细胞相关分子检测组合在血液学标本诊断检查中的效用。
设计、地点和患者：将一个PCR检测组合应用于来自87例患者的89份标本，包括55例（57份标本）已知的单克隆B细胞淋巴瘤、10例霍奇金病、2例T细胞淋巴瘤以及20份多克隆反应性淋巴组织标本。该检测组合包括用于免疫球蛋白重链（IgH）基因重排的半巢式PCR程序以及用于检测t(14;18)和t(11;14)的非巢式PCR。
在所有B细胞淋巴瘤病例中，63%检测到免疫球蛋白重链，35%检测到t(14;18)，3.5%检测到t(11;14)。使用这些引物，77%的病例显示出IgH和/或bcl-2相关的易位。仅IgH引物在82%（28/34）的非滤泡性淋巴瘤和35%（8/23）的滤泡性淋巴瘤中检测到克隆性，在非B细胞淋巴瘤标本中无假阳性。添加用于检测IgH和bcl-2/JH的两组引物显著提高了滤泡性淋巴瘤组分子异常的检测率，从35%提高到70%（16/23）。然而，非滤泡性淋巴瘤组的总体检测率未发生变化。添加用于bcl-1/JH的引物对两组的总体检测率均无影响。
IgH的半巢式PCR在大多数非滤泡性淋巴瘤中检测到单克隆性，是该组中有价值的诊断工具。检测IgH基因重排和bcl-2/JH的不同引物组合对滤泡性淋巴瘤最为适用。
