【摘要】 目的探讨桥本甲状腺炎(HT)和甲状腺原发性淋巴瘤(PTL)的免疫球蛋白(Ig)基因重排特点及2种疾病的相关关系。方法收集PTL11例(PTL组),HT38例(按组织形态学分为HT组和可疑PTL组),以及相关临床资料。应用PCR技术,采用VH、FR3A、FR3κ共3对引物,对3组标本的Ig重链和轻链的基因重排情况进行检测。结果可疑PTL组重排单克隆率(40·0%)显著高于HT组(10·7%);PTL组重排单克隆率(72·7%)显著高于可疑PTL组。各组女性患者均显著高于男性,但PTL组男性比例较前两组有所提高。3组病变患者甲状腺球蛋白抗体及甲状腺过氧化物酶抗体的滴度与重排结果无关联。结论PTL与HT在形态学上有交叉,通过PCR技术对这2种疾病中淋巴组织的Ig基因重排的检测,提示桥本甲状腺炎可能进展到甲状腺淋巴瘤,基因重排出现单克隆性早于形态学表现。更多还原

【Abstract】 Objective To study the immunoglobulin gene rearrangement patterns in Hashimoto′s thyroiditis (HT) and primary thyroid lymphoma (PTL), and to analyze the relationship between the two diseases. Methods Formalin-fixed and paraffin-embedded tissues of 11 cases of PTL and 38 cases of HT as well as their clinical data, were retrieved. The latter group was further subcategorized into classic HT and suspicious PTL. Gene rearrangement studies for immunoglobulin heavy chains and light chains were carried out by polymerase chain reaction (PCR) using VH, FR3A and FR3κ primers. Results There was an increasing trend in immunoglobulin gene rearrangement rate for classic HT (10.7%), suspicious PTL (40.0%) and PTL (72.7%) groups. In general, a female predilection was observed. This sex predilection however was less obvious in the PTL group. There was no relationship between serum antibody (both thyroglobulin and thyroid peroxidase) titers and gene rearrangement patterns. Conclusions HT and PTL show morphologic overlaps and may not be clearly distinguished on the basis of light microscopy alone. PCR-based immunoglobulin gene rearrangement study may be helpful in the detection of cases with early lymphomatous transformation of HT.更多还原