论文部分内容阅读
检测各种血液系统肿瘤患者外周血细胞免疫球蛋白重链基因 (IgH )和T细胞受体γ基因 (TCRγ )克隆性重排并探讨其意义。通过多聚酶链式反应 (PCR )方法检测 32例非霍奇金淋巴瘤 (NHL )、 18例急性髓性白血病 (AML )、 2 4例多发性骨髓瘤 (MM )、 8例急性淋巴细胞白血病 (ALL )及 6例慢性淋巴细胞白血病 (CLL )患者外周血细胞IgH及TCRγ克隆性基因重排。结果表明 ,NHL、AML、MM、ALL及CLL患者中IgH克隆性重排率分别为 37 5 0 %、 2 2 2 2 %、 83 33%、 12 5 0 %和 16 6 7% ;TCRγ基因克隆性重排率分别为 6 2 5 0 %、 5 0 0 0 %、 5 4 17%、 5 0 0 0 %及 5 0 0 0 %。在B型、T型NHL中 ,IgH克隆性重排率分别为 31 5 8%及 6 6 6 7% ;TCRγ克隆性重排率分别为 47 37%及 6 6 6 7%。AML中IgH克隆性重排阳性者的初治完全缓解率(CR ) (5 0 0 0 % )与IgH重排阴性的初治CR率 (5 0 0 0 % )无显著差异 (P >0 0 5 )。TCRγ克隆性重排阳性者与阴性者的初治CR率 (均为 44 44 % )亦无显著差异 (P >0 0 5 )。IgH及TCRγ基因克隆性重排不具有细胞谱系的特异性 ,但通过检测外周血IgH、TCRγ克隆性基因重排对NHL有辅助诊断意义 ,并且可作为监测微小残留病壮 (MRD )的手段。
To detect the clonal rearrangement of peripheral blood cell immunoglobulin heavy chain gene (IgH) and T cell receptor gamma gene (TCRγ) in patients with various hematological malignancies and explore its significance. 32 cases of non-Hodgkin lymphoma (NHL), 18 cases of acute myeloid leukemia (AML), 24 cases of multiple myeloma (MM), and 8 cases of acute lymphoblastic leukemia were detected by polymerase chain reaction (PCR). Peripheral blood cell IgH and TCRγ clonal gene rearrangement in ALL and 6 patients with chronic lymphocytic leukemia (CLL). The results showed that the clonal cloning rates of IgH in patients with NHL, AML, MM, ALL, and CLL were 37 50%, 2 2 2%, 83 33%, 1250%, and 16 67%, respectively; TCRγ gene cloning The sexual rearrangement rates were 6 2 50%, 50%, 54%, 50%, and 50%. In the B-type and T-type NHLs, the clonal rearrangement rates of IgH were 315.8% and 666.7%, respectively; the clonal cloning rates of TCRγ were 47.37% and 666.7%, respectively. There was no significant difference in the initial response rate (CR) (500%) between patients with positive IgH clonal rearrangement in AML and the initial treatment CR rate (500%) with negative IgH rearrangement (P > 0 0). 5). There was also no significant difference in the initial CR rate (44 44%) between positive and negative TCRγ clonal rearrangements (P > 0.05). The clonal rearrangement of IgH and TCRγ genes does not have the specificity of the cell lineage, but it can be used as a means to monitor the MRD of small residual disease by detecting peripheral blood IgH and TCRγ clonal gene rearrangement.