Gene Expression Profiling

The profound effect of the advent of immunohisto-chemistry on lymphoma classification, outlined above, is likely to be repeated once the new gene array techniques24 move out of the academic research area into diagnostic pathology laboratories. This technique permits automated, semiquantitative comparative analysis of the expression of thousands of genes (the entire human genome) from RNA extracted from a small sample of fresh tissue. By simultaneous analysis of a large number of cases of lymphoma, those with identical and distinctive patterns of either overexpression or underexpression of certain genes can be identified and recognized (i.e., classified) as distinctive diseases. The power of this technique, with regard to lymphoma classification, was first demonstrated in a series of DLBCLs25 (see below) and it is likely that as more studies are completed considerable changes in lymphoma classification will follow. Unlike previous changes in lymphoma classification, however, the broad principles of the WHO classification are unlikely to change.

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