engleski

THE ROLE OF CLONALITY TESTING IN DISCRIMINATION BETWEEN REACTIVE AND MALIGNANT PROLIFERATIONS

Aim: Molecular analysis of T cell receptor (TCR) and immunoglobulin (Ig) genes rearrangement is often a useful adjunct to the patohistological diagnosis (PHD) in discrimination between reactive and malignant proliferations, specially in cases of clinically suspected lymphoproliferative disorders (LPDs). The aim of the study was to investigate weather the routine application of molecular analysis of TCRb/TCRc/IgH/IgK genes rearrangement could support the PHD of reactive proliferations in cases of clinically suspected malignant proliferations. Methods: Patohistological analysis of paraffin- embedded tissues together with FISH in a case was done. Afterwards molecular analysis of TCRb/TCRc/IgH/IgK genes rearrangement were performed by multiplex polymerase-chain reactions (PCRs) standardized according the BIOMED-2 Concerted Action protocols and accredited according ISO15189 standard. Proper analytical results of molecular analysis of TCR/Ig genes rearrangement were confirmed by participation in independent External Quality Assurance (EQA)scheme Molecular Diagnosis of Haematological Malignancies(MDHM) organized by UK NEQAS. Clonal TCR/Ig genes rearrangement was identified as single-sized PCR products inside the valid size range. Results: In cases of clinically suspected malignant proliferation both PHDs were reactive benign proliferations based on negative FISH. In one case molecular analysis of Ig genes demonstrated polyclonal IgH/IgK genes rearrangement while in other only clonal TCRc gene rearrangement. In case of clinically suspected reactive proliferation PHD of reactive benign proliferation was also supported by polyclonal TCRb/TCRc genes rearrangement. Conclusion: Our selected cases of daily practice have shown that PHD could benefit from routine application of molecular TCRb/TCRc/IgH/IgK genes rearrangement analysis which assures proper analytical results.

clonality testing; reactive proliferations; malignant proliferations

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