Abstract

BackgroundImmunoglobulin heavy chain (IgH) gene rearrangement test is a standard tool in diagnosing B-cell lymphoma. The BIOMED-2 multiplex PCR protocol has become the most commonly used laboratory method for detecting clonal IgH gene rearrangement. However, post-PCR procedure requires manual transfer of PCR product for analysis and is time-consuming. A novel strategy using LightCycler to continuously monitor fluorescence during melting curve analysis (MCA) can overcome these shortcomings. The previous studies published on this method were all restricted to FR3 primers of BIOMED-2.MethodsReal-time PCR and subsequent MCA were performed on 71 clinical DNA samples from formalin-fixed, paraffin-embedded tissues, including 40 with B-cell non-Hodgkin lymphomas and 31 with reactive lymphoid hyperplasia. We optimized the current method using FR3 primers and applied FR2 primers for the first time into MCA to detect IgH gene rearrangement. Polyacrylamide gel electrophoresis and capillary gel electrophoresis were also performed on all lymphoma samples with the identical FR2 primers.ResultsMCA of combined FR2 and FR3 primer sets yielded the sensitivity and the specificity equal to 70 % (28/40) and 100 % (31/31), respectively. Addition of FR2 primers increased the sensitivity by 12.5 % (5/40) comparing to FR3 primers alone. MCA was slightly more sensitive than polyacrylamide gel electrophoresis and comparable to capillary gel electrophoresis to detect clonal IgH gene rearrangement.ConclusionsCombined PCR and DNA melting curve analysis in a closed system can reduce cross-contamination risk. This method can test 96 samples simultaneously within 90 min and therefore, it is high-throughput and faster. PCR-MCA in the LightCycler system has potential for evaluating monoclonal IgH gene rearrangement in a clinical environment.

Highlights

  • Immunoglobulin heavy chain (IgH) gene rearrangement test is a standard tool in diagnosing B-cell lymphoma

  • The result showed that all reactive samples as well as the negative control had flat, wide, irregular peaks with -dF/dT values less than 3.5 for framework region 2 (FR2) or less than 2.5 for framework region 3 (FR3)

  • The criteria for diagnosing a monoclonal IgH gene rearrangement were established as having a single sharp peak with the -dF/dT value equal to or greater than 3.5 for FR2 and 2.5 for FR3, respectively

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Summary

Introduction

Immunoglobulin heavy chain (IgH) gene rearrangement test is a standard tool in diagnosing B-cell lymphoma. Xu et al [11] developed a novel PCR method for detecting clonal IgH-R that continuously monitored fluorescence of the specific double-stranded DNA binding dye SYBR green I during melting curve analysis (MCA) on LightCycler. This method that used the FR3 primer set of BIOMED-2 was faster and reliable, and combined PCR and DNA MCA in a closed system reduced post-PCR crosscontamination risk. We include FR2 primers for the first time into the protocol, and demonstrate that PCR in LightCycler system with melting curve analysis using combined FR2 and FR3 primers can increase the detection sensitivity, and is a reliable and reproducible method to diagnose the monoclonal IgH gene rearrangements

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