림프구성 종양의 클론성 분석을 위하여 중합효소연쇄반응을 이용한 면역글로불린 중쇄와 T-세포 수용체 감마쇄 유전자 재배열 검사의 진단적 유용성
Diagnostic Utility of Polymerase Chain Reaction-Based Clonality Analysis for Immunoglobulin Heavy Chain Gene and T-cell Receptor Gamma Chain Gene Rearrangement in Lymphoid Neoplasms
조은윤, 고영혜, 김대식, 한재준, 이회정,
소속 상세정보
조은윤 ( Cho Eun-Yoon )
성균관대학교 의과대학 삼성서울병원 진단병리과
고영혜 ( Ko Young-Hyeh )
성균관대학교 의과대학 삼성서울병원 진단병리과
김대식 ( Kim Dae-Shick )
성균관대학교 의과대학 삼성서울병원 진단병리과
한재준 ( Han Jae-Joon )
성균관대학교 의과대학 삼성서울병원 진단병리과
이회정 ( Ree Howe-J. )
성균관대학교 의과대학 삼성서울병원 진단병리과
KMID : 0357920010350060461
Abstract
Background: The clonality of lymphoid infiltrates determined by polymerase chain reaction (PCR) for immunoglobulin heavy chain (IgH) or T cell receptor (TCR) genes is not only useful in confirming the diagnosis of malignant lymphoma but also in establishing the lineage of a clonal lymphoid proliferation. We analyzed the efficiency of PCR analyses for IgH and TCRγgenes that have been routinely applied for the diagnosis of malignant lymphoma in our laboratory.
Methods: Paraffin sections of 200 cases were analyzed by seminested PCR. Primers were FRIIIA-LJH/VLJH consensus primer for IgH gene and Vγ-Jγ consensus primer for TCRγ gene. The cases showing negative results by PCR for TCRγ gene were further analyzed by multiplex Vγ family primers with heteroduplex analysis.
Results: PCR approach for IgH gene allowed detection of clonality in 100% of cases with false positive rate of 0.3% and false negative rate of 0%. The combination of PCR for TCRγ consensus primers with multiplex Vγ family primers allowed detection of clonality in 91% of cases with false positive rate of 0.6% and false negative rate of 10.3%.
Conclusions: Combined analysis of IgH and TCR gene rearragnements by the PCR technique followed by heteroduplex analysis can be a useful diagnostic adjunct to determine the clonality of various lymphoproliferative diseases with high sensitivity. But clinical, morphological and immunophenotypical correlation should be considered to reach the final diagnosis due to a few false positive cases.
키워드
Lymphoma;Polymerase Chain Reaction
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