本文選題：非霍奇金淋巴瘤　切入點：免疫球蛋白重鏈　出處：《第一軍醫(yī)大學》2006年碩士論文　論文類型：學位論文

【摘要】：一、研究背景和目的 淋巴瘤病理診斷是臨床病理診斷的難題之一，2001年世界衛(wèi)生組織(WHO)定義惡性淋巴瘤中每一個獨立疾病(或類型)需要結合形態(tài)學、免疫表型、遺傳學和臨床特點來確定，特別強調基因重排檢測技術輔助診斷淋巴瘤的重要性。大部分可疑的高度反應增生性淋巴組織，可以通過組織形態(tài)學和細胞形態(tài)學結合免疫組化或流式細胞技術檢測免疫表型來與惡性淋巴瘤甄別。但還有大約5～15％的病例難以確診。原則上，惡性淋巴瘤的瘤細胞都來自一個共同的克隆，所以能夠依靠克隆性鑒定來進行輔助診斷。 淋巴細胞惡性腫瘤以B細胞來源為主，約占90％，免疫球蛋白重鏈基因(IgH)分析方法主要有DNA印跡法(Southern blot)、PCR、測序等。以PCR技術為基礎的方法以其簡便、高效、廉價及適用面廣而在淋巴瘤基因重排研究方面越來越受重視。但不同研究文獻中所采用的引物、PCR條件、PCR產物檢測方法等都不盡相同，結果也有差異。難以找到適于常規(guī)臨床病理診斷的標準程序，影響了PCR技術的應用價值。 2003年歐洲七國47個研究所的病理學家、分子生物學家及其它研究人員經過四年半的研究發(fā)表了標準化引物系統(tǒng)(BIOMED-2)，建立了用于克隆性分析的基因重排及染色體易位檢測的PCR方法學和引物設計的標準化，可檢測出幾乎所有克隆性T、B細胞克隆細胞群乃至高度體細胞突變B細胞淋巴瘤／白血病，實現(xiàn)了前所未有高檢出率。BIOMED-2引物系統(tǒng)是劃時代的，其設計思想十分先進，，將該技術進一步完善并及早運用于臨床已勢在必行，但該系統(tǒng)過于龐大復雜，目前在國內難以推廣應用，更不利于臨床診斷的使用。本研究以淋巴瘤
[Abstract]:I. background and purpose of the study. The pathological diagnosis of lymphoma is one of the difficult problems in clinicopathological diagnosis. In 2001, the World Health Organization (WHO) defined each individual disease (or type) in malignant lymphoma to be determined by combining morphology, immunophenotype, genetics and clinical characteristics. Emphasizing in particular the importance of gene rearrangement techniques to assist in the diagnosis of lymphoma. Most suspicious highly reactive proliferative lymphoid tissues, Histomorphology and cell morphology combined with immunohistochemistry or flow cytometry can be used to detect the immunophenotype of malignant lymphoma. But there are still about 55% of the cases that are difficult to diagnose. In principle, Malignant lymphoma cells are derived from a common clone, so can rely on clonal identification to assist the diagnosis. The immunoglobulin heavy chain gene (Ig) analysis method mainly includes DNA blotDNA, sequencing and so on. The method based on PCR technique is simple and efficient. More and more attention has been paid to the gene rearrangement of lymphoma due to its low cost and wide application. It is difficult to find a standard procedure suitable for routine clinicopathologic diagnosis, which affects the application value of PCR technique. In 2003, pathologists at 47 institutes in seven European countries, After four and a half years of research, molecular biologists and other researchers have published a standardized primer system, BIOMED-2, and established PCR methodology and standardization of primer design for gene rearrangement and chromosome translocation detection for clonal analysis. It can detect almost all clone T B cell colony and even high somatic mutation B cell lymphoma / leukemia. It is epochal to realize the unprecedented high detection rate of BIOMED-2 primer system, and its design idea is very advanced. It is imperative to improve the technique and apply it to clinical practice as soon as possible, but the system is too large and complex, so it is difficult to be popularized and applied in China at present, which is even more unfavorable for clinical diagnosis.
【學位授予單位】：第一軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2006
【分類號】：R392

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