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目的：为研究非霍奇金氏恶性淋巴瘤（ＮＨＬ）的骨髓微小病灶及其临床意义。方法：采用ＰＣＲ技术联合检测４２例ＮＨＬ患者骨髓标本免疫球蛋白重链（ＩｇＨ）、Ｔ细胞受体（ＴＣＲ）ＶγＩ－Ｊｒ及ＴＣＲＶδ２－Ｄδ３重排基因。结果：３０．９％（１３／４２）存在ＩｇＨ重排，２３．８％（１０／４２）存在ＴＣＲＶγＩ－Ｊγ重排，１９．０％（８／４２）存在ＴＣＲＶδ２－Ｄδ３重排；联合检测三个重排基因，总阳性率为４２．９％（１８／４２）。而骨髓形态学检查的阳性率仅为１９．０％（８／４２）。ＰＣＲ检测ＮＨＬ骨髓浸润的阳性率显著高于形态学检查（Ｐ＜０．０１）。对其中６例ＰＣＲ检测阳性而形态学检查阴性病例追踪观察发现，３～８月后病人形态学检查均发现骨髓浸润，ＰＣＲ检测阳性较形态学检查平均提前４．８３月。结论：ＰＣＲ检测ＮＨＬ患者骨髓重排基因能早期发现微小病灶且阳性率高，有助于预后判断。
OBJECTIVE: To study the microbone lesions of non-Hodgkin’s malignant lymphoma (NHL) and its clinical significance. METHODS: PCR was used to detect the rearrangement of the immunoglobulin heavy chain (IgH), TCR VγI-Jr and TCR Vδ2-Dδ3 rearrangement genes in 42 NHL patients. RESULTS: IgH rearrangement was found in 30.9% (13/42), TCRVγI-Jγ rearrangement in 23.8% (10/42), and rearrangement of TCRVδ2-Dδ3 in 19.0% (8/42); For the three rearranged genes, the overall positive rate was 42.9% (18/42). The positive rate of bone marrow morphological examination was only 19.0% (8/42). The positive rate of NHL bone marrow infiltration detected by PCR was significantly higher than that of morphological examination (P<0.01). A follow-up observation of 6 cases of positive PCR and negative morphological examination found that bone marrow infiltration was found in 3 to 8 months after the morphological examination. The average PCR detection was 4.83 months earlier than the morphological examination. Conclusion: PCR detection of NHL patients with bone marrow rearrangement gene can detect small lesions early and have a high positive rate, which is helpful for prognosis.