摘要
目的探讨Ig重链蛋白、IgH基因重排/断裂在黏膜相关淋巴组织淋巴瘤(mucosa-associated lymphoid tissue lymphoma,MALToma)诊断中的应用价值。方法选取40例MALToma作为实验组,15例反应性淋巴组织增生(reactive lymphoid hyperplasia,RLH)作为对照组,应用免疫组化、PCR、FISH技术分别检测两组中Ig重链蛋白、IgH基因重排、IgH基因断裂情况。结果(1)Ig重链蛋白表达根据免疫组化结果可分为三种模式:单种Ig重链蛋白表达(模式Ⅰ)、Ig重链蛋白全阴性(模式Ⅱ)、多种Ig重链蛋白表达(模式Ⅲ)。实验组模式Ⅰ/Ⅱ的阳性率(87.5%)显著高于对照组(0)(P<0.01)。(2)实验组IgH基因重排、IgH基因断裂的阳性率分别为72.5%(29/40)、32.5%(13/40),而对照组未检出IgH基因重排、IgH基因断裂(P<0.01,P<0.05)。(3)Ig重链蛋白模式Ⅰ/Ⅱ和IgH基因重排联合检测以及Ig重链蛋白模式Ⅰ/Ⅱ、IgH基因重排和IgH基因断裂联合检测的阳性率均高达97.5%。(4)在Ig重链蛋白模式Ⅱ中,有9例检出IgH基因断裂(90%);在模式Ⅰ/Ⅲ中,仅有4例检出IgH基因断裂(13.3%),两组相比差异有统计学意义(P<0.01)。Ig重链蛋白表达和IgH基因断裂呈正相关(r s=0.323,P<0.05)。结论联合检测Ig重链蛋白表达模式和IgH基因重排可有效辅助鉴别MALToma和RLH;IgH基因断裂可能与Ig重链蛋白表达缺失高度相关。
Purpose To investigate the value of Ig heavy chain protein expression and IgH gene rearrangement/split in the diagnosis of mucosa-associated lymphoid tissue lymphoma(MALToma).Methods 40 cases of MALToma were selected as experimental group and 15 cases of reactive lymphoid tissue hyperplasia(RLH)as control group.Immunohistochemistry,polymerase chain reaction and fluorescence in situ hybridization were used to detect Ig heavy chain protein,IgH gene rearrangement and IgH gene breakage in the two groups,respectively.Results According to the results of immunohistochemistry,the expression of Ig heavy chain protein was divided into three patterns:single Ig heavy chain protein expression(mode I),all negative expression of Ig heavy chain protein(modeⅡ),and multiple Ig heavy chain proteins expression(modeⅢ).The positive rate of modeⅠ/Ⅱin the experimental group(87.5%)was significantly higher than that in the control group(0)(P<0.01).The positive rates of IgH gene rearrangement and IgH gene split in the experimental group were 72.5%(29/40)and 32.5%(13/40)respectively,while none were detected in the control group(P<0.01 and 0.05,respectively).The positive rates of combined detection of Ig heavy chain protein patternⅠ/Ⅱand gene rearrangement and combined detection of Ig heavy chain protein patternⅠ/Ⅱ,IgH gene rearrangement and IgH gene breakage were as high as 97.5%.In modeⅡ,IgH gene breakage was detected in 9 cases(90%),while in modeⅠ/Ⅲ,it was detected in only 4 cases(13.3%),with a significant difference between the two groups(P<0.01).The correlation between Ig heavy chain protein expression and IgH gene split was present(r s=0.323,P<0.05).Conclusion Combined detection of Ig heavy chain protein expression pattern and IgH gene rearrangement can effectively assist in the differentiation between MALToma and RLH.IgH gene breakage may be highly correlated with the loss of Ig heavy chain protein expression.
作者
王红霞
陈昊
林海月
聂艳红
齐冬雪
江亚军
WANG Hong-xia;CHEN Hao;LIN Hai-yue;NIE Yan-hong;QI Dong-xue;JIANG Ya-jun(Department of Pathology,the First People’s Hospital of Lianyungang,Lianyungang 222000,China;Department of Pathology,Jiading District Central Hospital,Shanghai 201800,China;Department of Hematology,Jiading District Central Hospital,Shanghai 201800,China)
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2019年第8期902-906,共5页
Chinese Journal of Clinical and Experimental Pathology
基金
连云港市卫生计生科技项目(201701)
连云港市“科教强卫工程”青年科技项目(QN1605)
