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目的本研究采用PCR联合单链构象多态性技术(single strand conformation polymorphism,SS-CP)分析检测TCRVγⅠ—Jγ基因重排在常见血液病的中的表达,结合临床资料初步探讨TCRVγⅠ—Jγ基因重排在常见血液病的中的表达差异和临床意义。方法应用PCR对115例血液病的骨髓进行TCRVγⅠ—Jγ基因重排检测,阳性者行SSCP分析。结果⑴TCRVγⅠ-Jγ基因重排在急性淋巴细胞白血病、淋巴瘤、急性非淋巴细胞性白血病、骨髓增生异常综合征、再生障碍性贫血、特发性血小板减小性紫癜、免疫相关性血细胞减少症和系统性红斑狼疮的阳性率分别为77.78%、71.43%、21.62%、33.33%、77.78%、66.67%、50.00%和100%。⑵急性淋巴细胞白血病部分缓解、完全缓解患者与初治患者积分有显著差异(P值分别为0.013、0.02)。在SSCP中,TCRVγⅠ-Jγ基因重排在不同血液病中表达不同,恶性肿瘤患者表现为单克隆带/有优势寡亚克隆带,非恶性肿瘤患者表现为无优势寡亚克隆带/多克隆带,两者差异显著(P<0.01)。结论(1)TCRVγⅠ-Jγ基因重排检测对淋巴系统恶性肿瘤的诊断有辅助作用。(2)急性非淋巴细胞性白血病、骨髓增生异常综合征也存在TCRVγⅠ-Jγ基因重排。(3)PCR-SSCP检测TCRVγⅠ-Jγ基因重排对良、恶性血液病的鉴别有一定意义。
Objective To investigate the expression of TCRVγⅠ-Jγ gene rearrangements in common hematologic diseases by single strand conformation polymorphism (SS-CP) analysis and clinical data. Row differences in the expression of common hematological diseases and clinical significance. Methods The bone marrow of 115 cases of hematological diseases were detected by TCRVγⅠ-Jγ gene rearrangement by PCR. The positive cases were analyzed by SSCP. Results ⑴TCRVγⅠ-Jγ gene rearrangement in acute lymphoblastic leukemia, lymphoma, acute non-lymphocytic leukemia, myelodysplastic syndrome, aplastic anemia, idiopathic thrombocytopenic purpura, immune-related cytopenia and The positive rates of systemic lupus erythematosus were 77.78%, 71.43%, 21.62%, 33.33%, 77.78%, 66.67%, 50.00% and 100%, respectively. ⑵ Acute lymphoblastic leukemia partially relieved, patients with complete remission and treatment of patients with a significant difference (P values were 0.013,0.02). In SSCP, TCRVγⅠ-Jγ gene rearrangements were expressed differently in different hematological diseases. Malignant tumors showed monoclonal bands / predominant oligo-subclones, and non-malignant tumors showed no predominant oligo- / polyclonal bands , Significant difference between the two (P <0.01). Conclusion (1) The TCRVγⅠ-Jγ gene rearrangement test has an auxiliary role in the diagnosis of lymphoid malignancies. (2) acute non-lymphocytic leukemia, myelodysplastic syndrome TCRVγ Ⅰ-Jγ gene rearrangement. (3) PCR-SSCP detection of TCRVγ Ⅰ-Jγ gene rearrangement of benign and malignant hematological disease has some significance.