Published online before print May 10, 2007

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Copyright © 2007 American Society for Investigative Pathology
Journal of Molecular Diagnostics, doi:10.2353/jmoldx.2007.050129

Accepted for publication January 17, 2007.

Article

Analytical Detection of Immunoglobulin Heavy Chain Gene Rearrangements in Gastric Lymphoid Infiltrates by Peak Area Analysis of the Melting Curve in the LightCycler System

Eduardo Retamales^*, Luis Rodriguez^*, Leda Guzman, Francisco Aguayo, Mariana Palma, Claudia Backhouse, Jorge Argandona^*, Erick Riquelme, and Alejandro Corvalan^@

From the Departamento Laboratorio de Salud,* Instituto Salud Publica de Chile, Santiago; Facultad de Salud, Universidad Santo Tomas, Santiago; Instituto Chileno-Japones de Enfermedades Digestivas, Hospital San Borja Arriaran Universidad de Chile, Santiago; and Departmento Anatomía Patológica, Pontificia Universidad Catolica de Chile, Santiago, Chile

^@ To whom correspondence should be addressed. E-mail: corvalan{at}med.puc.cl.

	Abstract

Because it is difficult to differentiate gastric mucosa-associated lymphoid tissue (MALT) lymphoma from chronic gastritis in gastric lymphoid infiltrates, molecular detection of monoclonality through immunoglobulin heavy chain (IgH) gene rearrangements is commonly performed. However, heterogeneity in the performance and results obtained from IgH gene rearrangements has been reported. To improve the accuracy in the diagnosis of gastric lymphoid infiltrates, we developed an analytical approach based on one-peak area analysis of the melting curve in the LightCycler System. Using a training-testing approach, the likelihood ratio method was selected to find a discriminative function of 4.64 in the training set (10 gastric MALT lymphomas and 10 chronic gastritis cases). This discriminative function was validated in the testing set (five gastric MALT lymphomas, six abnormal lymphocytic infiltrates with subsequently demonstrated gastric MALT lymphomas, and six cases of chronic gastritis). All but one case of gastric MALT lymphoma, as well as abnormal lymphocytic infiltrates, clustered under 4.64, and all chronic gastritis cases clustered above 4.64. These results were validated by conventional electrophoreses confirming one or two sharp bands in cases of gastric MALT lymphomas and a smear of multiple bands in cases of chronic gastritis. Analytical detection of IgH gene rearrangement in gastric lymphoid infiltrates by one-peak area analysis correctly distinguishes gastric MALT lymphomas from chronic gastritis, even in cases with diagnosis of abnormal lymphocytic infiltrates.

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