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目的探讨桥本甲状腺炎(HT)和甲状腺原发性淋巴瘤(PTL)的免疫球蛋白(Ig)基因重排特点及2种疾病的相关关系。方法收集PTL11例(PTL组),HT38例(按组织形态学分为HT组和可疑PTL组),以及相关临床资料。应用PCR技术,采用VH、FR3A、FR3κ共3对引物,对3组标本的Ig重链和轻链的基因重排情况进行检测。结果可疑PTL组重排单克隆率(40·0%)显著高于HT组(10·7%);PTL组重排单克隆率(72·7%)显著高于可疑PTL组。各组女性患者均显著高于男性,但PTL组男性比例较前两组有所提高。3组病变患者甲状腺球蛋白抗体及甲状腺过氧化物酶抗体的滴度与重排结果无关联。结论PTL与HT在形态学上有交叉,通过PCR技术对这2种疾病中淋巴组织的Ig基因重排的检测,提示桥本甲状腺炎可能进展到甲状腺淋巴瘤,基因重排出现单克隆性早于形态学表现。
Objective To investigate the characteristics of immunoglobulin (Ig) rearrangement in Hashimoto’s thyroiditis (HT) and thyroid primary lymphoma (PTL) and the relationship between the two diseases. Methods PTL was collected from 11 patients (PTL group) and HT38 patients (grouped according to histomorphology into HT group and suspected PTL group), and relevant clinical data. PCR was used to detect the gene rearrangement of Ig heavy and light chains in three groups using three pairs of primers: VH, FR3A and FR3κ. Results The percentage of monoclonal antibodies in the suspected PTL group (40.0%) was significantly higher than that in the HT group (10.7%). The rate of monoclonal rearrangement in the PTL group (72.7%) was significantly higher than that in the suspected PTL group. The female patients in each group were significantly higher than men, but the proportion of males in the PTL group was higher than that in the previous two groups. The titers of thyroglobulin antibodies and thyroid peroxidase antibodies in three groups of patients were not related to the results of rearrangement. Conclusion The morphology of PTL and HT overlaps. The detection of Ig gene rearrangement of lymphoid tissues in these two diseases by PCR technique suggests that Hashimoto’s thyroiditis may progress to thyroid lymphoma, and the gene rearrangement appears to be monoclonal. For morphological performance.