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目的探讨PCR检测免疫球蛋白重链基因重排在鉴别儿童良恶性淋巴组织增生性疾病中的应用价值。方法选取存档蜡块24例,采用HE常规染色,SP免疫组织化学方法 ,确诊为小无裂细胞性淋巴瘤11例,淋巴母细胞型8例,大细胞性淋巴瘤5例。石蜡组织切片常规酚-氯仿法抽提DNA,采用半巢式PCR扩增免疫球蛋白重链基因重排,20g.L-1琼脂糖凝胶电泳检测PCR产物。结果 24例儿童非霍奇金淋巴瘤中免疫球蛋白重链基因检测淋巴瘤18例(包括小无裂细胞性淋巴瘤9例,淋巴母细胞型5例,大细胞性淋巴瘤4例),检测率75%。结论 PCR检测免疫球蛋白重链基因重排可作为淋巴瘤的辅助诊断方法 ,一定程度上能够对部分疑难病例确诊,做到早诊断、早治疗。
Objective To investigate the value of PCR detection of immunoglobulin heavy chain gene rearrangements in differential diagnosis of benign and malignant lymphoproliferative diseases in children. Methods 24 cases of preserved paraffin blocks were selected. Eleven small aptoplasitic lymphoma, eight lymphoblastoid cell types and five large cell lymphomas were confirmed by HE staining and SP immunohistochemistry. Paraffin tissue sections were subjected to conventional phenol-chloroform extraction of DNA. Semi-nested PCR was used to amplify immunoglobulin heavy chain gene rearrangements. PCR products were detected by 20g.L-1 agarose gel electrophoresis. Results Twenty - four cases of lymphoma (including 9 cases of small acytopathic lymphoma, 5 cases of lymphoblastoid cell and 4 cases of large cell lymphoma) were detected by immunoglobulin heavy chain gene in 24 cases of children with non - Hodgkin ’s lymphoma. Detection rate of 75%. Conclusion PCR detection of immunoglobulin heavy chain gene rearrangement can be used as an auxiliary diagnosis of lymphoma, to some extent, can be diagnosed in some difficult cases, so early diagnosis and early treatment.