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目的淋巴瘤的发生被认为是B或T淋巴细胞被阻断在其分化过程中某一阶段而造成淋巴细胞的克隆性增生所致。多数淋巴系统增生性疾病通过组织形态学和免疫表型分析能够明确诊断,但对于T细胞淋巴瘤(T cell Lymphoma,TCL)的诊断,仅凭形态学与免疫表型分析难以明确。本研究旨在探讨毛细管电泳技术在TCL诊断中的应用价值。方法回顾性分析2014-01-04-2015-06-30齐鲁医学检验所经形态学和免疫组织化学诊断的TCL和不能明确诊断的淋巴组织增生性病变共63例,利用毛细管电泳基因片段分析技术分析基因重排产物的克隆性。结果 25例TCL中,T细胞受体-G(T-cell receptor G,TCRG)、TCRB、TCRD基因重排的检出率分别为88.0%(22/25)、72.0%(18/25)和20.0%(5/25),三者联合检出率为96.0%(24/25)。38例未明确诊断的淋巴组织增生性病变中,21例为多克隆性增生。结论毛细管电泳基因片段分析对TCL的诊断能够提供遗传学的支持,并且对形态学及免疫组化不典型或疑难病例可以提供诊断方向,利于TCL的病理诊断及鉴别诊断。
Purpose The occurrence of lymphoma is thought to be caused by the clonal proliferation of lymphocytes caused by the blockage of B or T lymphocytes at some stage during their differentiation. Most lymphatic system proliferative diseases can be diagnosed clearly by histomorphology and immunophenotyping, but the diagnosis of T cell lymphomas (TCL) is difficult to confirm by morphological and immunophenotypic analysis alone. The purpose of this study is to investigate the value of capillary electrophoresis in the diagnosis of TCL. Methods Retrospective analysis of 2014-01-04-2015-06-30 Qilu Medical test by morphological and immunohistochemical diagnosis of TCL and can not be clearly diagnosed lymphoproliferative lesions in 63 cases, the use of capillary electrophoresis gene fragment analysis Analysis of clonality of gene rearrangement products. Results The detection rates of T-cell receptor G (TCRG), TCRB and TCRD gene rearrangements were 88.0% (22/25), 72.0% (18/25) and 20.0% (5/25). The combined detection rate was 96.0% (24/25). Thirty-eight cases of undifferentiated lymphoproliferative lesions were diagnosed as polyclonal hyperplasia. Conclusion The analysis of gene fragments by capillary electrophoresis can provide genetic support for the diagnosis of TCL, and provide the diagnostic direction for the morphology and immunohistochemical atypical or difficult cases, which is beneficial to the pathological diagnosis and differential diagnosis of TCL.