CAJ | 학술논문

目的检测非霍奇金淋巴瘤(NHL)患者外周血血浆游离DNA免疫球蛋白重链(IgH)基因和T细胞受体γ(TCRγ)基因克隆性重排并探讨其临床意义.方法提取74例NHL患者血浆游离DNA并以Globin基因确定其存在,通过PCR方法检测IgH(FR3A/VLJH)和TCRγ(TVG/TJX)克隆性基因重排,并分别与外周血单个核细胞DNA、病理组织学检查进行比较.结果 74例患者中有58例(35例B-NHL和23例T-NHL)初诊、难治或复发的患者血浆游离DNA提取成功,另16例临床缓解患者未提取出血浆游离DNA.35例确诊的B-NHL患者中IgH基因单克隆重排阳性31例(88.6%),无一例出现TCRγ基因单克隆重排,23例确诊的T-NHL患者中TCRγ基因单克隆重排阳性8例(34.8%),其中2例同时出现IgH基因单克隆重排.在50例同时获得病理活检标本基因重排结果的病例中,30例B-NHL患者血浆DNA IgH基因重排阳性26例(86.7%),病理活检标本阳性24例(80.0%)(P＞0.05);20例T-NHL患者血浆DNA TCRγ基因重排阳性7例(35%),病理活检标本阳性6例(30%)(P＞0.05).结论 NHL患者血浆中可以检测出肿瘤源性的血浆游离DNA;NHL患者血浆游离DNA IgH、TCRγ基因重排的检测简单、方便、相对无创,与病理活检标本的检测具有相同的临床意义.
목적 검측비곽기금림파류(NHL)환자외주혈혈장유리DNA면역구단백중련(IgH)기인화T세포수체γ(TCRγ)기인극륭성중배병탐토기림상의의.방법 제취74례NHL환자혈장유리DNA병이Globin기인학정기존재,통과PCR방법 검측IgH(FR3A/VLJH)화TCRγ(TVG/TJX)극륭성기인중배,병분별여외주혈단개핵세포DNA、병리조직학검사진행비교.결과 74례환자중유58례(35례B-NHL화23례T-NHL)초진、난치혹복발적환자혈장유리DNA제취성공,령16례림상완해환자미제취출혈장유리DNA.35례학진적B-NHL환자중IgH기인단극륭중배양성31례(88.6%),무일례출현TCRγ기인단극륭중배,23례학진적T-NHL환자중TCRγ기인단극륭중배양성8례(34.8%),기중2례동시출현IgH기인단극륭중배.재50례동시획득병리활검표본기인중배결과 적병례중,30례B-NHL환자혈장DNA IgH기인중배양성26례(86.7%),병리활검표본양성24례(80.0%)(P＞0.05);20례T-NHL환자혈장DNA TCRγ기인중배양성7례(35%),병리활검표본양성6례(30%)(P＞0.05).결론 NHL환자혈장중가이검측출종류원성적혈장유리DNA;NHL환자혈장유리DNA IgH、TCRγ기인중배적검측간단、방편、상대무창,여병리활검표본적검측구유상동적림상의의.
Objective To evaluate the clinical significance of IgH and TCRγgene rearrangement in plasma free DNA in patients with non-Hodgkin Lymphoma(NHL).Methods Plasma free DNA in 74 patients with NHL were extracted and identified by Globin gene.IgH(FR3A/VLJH),TCRγ(TVG/TJX)clonal rearrangements were amplified by PCR and compared with results of mononuclear cell DNA and pathological biopsy sample DNA.Results Plasma free DNAs were successfully obtained from 58 cases(35 B-NHL and 23 T-NHL)of newly diagnostic,refractory and relapsed NHL out of total 74 patients(78.4%),but not found in the rest 16 patients in remission.Of 35 B-NHL cases,31 showed IgH rearrangement(88.6%),and none with TCRγrearrangement;of 23 T-NHL cases,8 showed TCRγ rearrangement(34.8%),and 2 with IgHgene rearrangement synchronously.In comparation with the results of IgH and TCRγgene rearrangement in biopsy samples in 30 B-NHL cases,26 cases in plasma free DNA(86.7%)and 24 in biopsy samples (80%)were positive(P＞0.05).In 20 T-NHL patiens,7 cases in plasma cell-free DNA(35%)and 6 cases in biopsy samples(30%)were positive(P＞0.05).Conclusions Tumor-derived DNA could be detected in plasma from underlying cancer patients.For NHL patients,detecting IgH and TCRγgene rearrangement in plasma free DNA has the same clinical significance as in biopsy samples.