The Role Of Ig Gene Rearrangement In The Pathological Diagnosis Of Non-hodgkin’s B-cell Lymphoma

Objectives Due to a wide range of categories, a part of lymphomas are still uncertainonly by morphological and immunohistochemical features. In the process ofdifferentiation and maturation of lymphocytes, the gene rearrangement had variety ofways because of antigen receptor gene rearrangement, SHM, and random insertion andloss of nucleotide. Each of lymphocytes has its own unique form. The lymphoma derivedfrom a single monoclonal proliferation of lymphocytes, and the antigen receptor generearrangement showed a single mode. So the diagnosis of lymphoma could be analyzedby molecular genetics. This study was designed to validate the value of Ig generearrangement in the diagnosis of lymphoma.Methods A number of cases were collected from Tangshan Municipal People’sHospital and reviewed the clinical, hematoxylin-eosin and immunohistochemical stains.These cases were classified according to WHO hematopoietic and lymphoid neoplasmsnew classification standards. Bone marrow biopsy of various of B-cell NHL wereanalyzed with SPSS20.0statistical software.The Ig gene rearrangement were amplifiedby multiplex primer polymerase chain reaction, analyzed the results by gel imageanalysis system.Results126cases were non-Hodgkin,s lymphoma. The commonest subtypes were:77cases of DLBCL,13cases of MALToma,12cases of FL,8cases of SLL,7cases of MCL,3cases of between DLBCL and CHL,2cases of NMZL,2cases of BL,1cases of B-LBL,1cases of SMZL. The ratio of male to female was1:1.2.The mean age atpresentation was60years (range23-84).72cases of bone marrow biopsy,23.6%(17/72)were involvement. Bone marrow of various lymphomas were: DLBCL23.5%, MCL85.7%, FL25%, B-LBL100%, BL50%, NMZL100%, SLL100%, MALToma0%.Except of the failure DNA, of45cases B cell NHL of experimental groups,37cases ofexperimental group were detected Ig gene rearrangement, the positive rate was82.2%.The positive rate of various lymphoma were MCL100%, SLL100%, B-cell lymphoma,unclassifiable,with features intermediate between DLBCL and CHL100%, BL100%,DLBCL92%, MALToma50%, two cases of NMZL and one case of B-LBL were negative.10cases of bone marrow involvement in the experimental group and the controlgroup were not detected Ig gene rearrangement.Conclusions The new classification standards combines tissue morphology, immunephenotype, genetics and clinical features. It provides an effective basis for lymphomaaccurate classification. Of126cases of non-Hodgkin’s B-cell lymphoma, diseaseincidence of extranodal lymphomas is higher than nodal lymphomas. The most commonsites are the digestive tract, tonsils, breast, reproductive system, liver, spleen, kidney,nasal cavity, brain, oral cavity, parotid gland, skin, lung, thyroid, bone, eyes, veins. Fiveof most common lymphomas are DLBCL, MALToma, FL, SLL, MCL. Done marrowinvolvement is an important basis for the clinical staging of lymphoma. The commonlyway is done marrow biopsy. In some cases, the done marrow biopsy is uniqueness andnecessity, immunohistochemistry is the important adjunct diagnostic tool of paraffin-embedded tissue of the bone marrow biopsy. Ig gene rearrangement has important valuein the diagnosis and differential diagnosis of non-Hodgkin’s B-cell lymphoma.It canimprove the accuracy of diagnosis of atypical lymph nodes and also be an effectiveidentification of benign and malignant of extranodal lymphoid tissue disease. However,because of its defective and non-specific bands, the diagnosis must be combined with HE,immunophenotype and clinical features. So it serve lymphoma diagnosis only as animportant auxiliary tool. The primers of Ig gene rearrangement were not amplifiedbecause of decalcified paraffin-embedded tissue of bone marrow biopsy. The significanceof Ig gene rearrangement in bone marrow biopsy needs to study further.