Blood cancer j:IGHV3-48基因的利用情况有望用于预测滤泡性淋巴瘤患者组织学转化的风险

2019-07-07 MedSci MedSci原创

滤泡性淋巴瘤(FL)是一种异质性疾病,其发病机制尚未完全明确。约20%的FL患者发生早期进展或难治性疾病,每年有2-3%的患者组织学转化(HT)为更具侵袭性的淋巴瘤(tFL)。研究人员对187例FL患者的免疫球蛋白重链变量(IGHV)基因的利用和突变情况进行评估,来探究其对临床预后和组织学转化的影响。在FL中,IGHV基因序列存在明显的偏倚。IGHV4-34(14%)、IGHV3-23(14%)、

滤泡性淋巴瘤(FL)是一种异质性疾病,其发病机制尚未完全明确。约20%的FL患者发生早期进展或难治性疾病,每年有2-3%的患者组织学转化(HT)为更具侵袭性的淋巴瘤(tFL)。

研究人员对187例FL患者的免疫球蛋白重链变量(IGHV)基因的利用和突变情况进行评估,来探究其对临床预后和组织学转化的影响。

在FL中,IGHV基因序列存在明显的偏倚。IGHV4-34(14%)、IGHV3-23(14%)、IGHV3-48(10%)、IGHV3-30(9%)和IGHV3-21(7%)基因占整个队列的一半以上。与5年未转化的FL相比,IGHV3-48在tFL病例中占比过高(19% vs 5%,p=0.05)。

与应用其他基因的患者相比,利用IGHV3-48基因的患者10年后更容易发生组织学转化(71% vs 25%,p<0.05),且无论进行怎样的治疗。此外,IGHV3-30在FL(9%)和tFL(13%)病例中的占比也明显高于弥漫性大B细胞淋巴瘤患者(几近为0)。

总而言之,本研究表明在FL的发生发展过程中,抗原选择起着重要作用,而IGHV3-48基因的利用情况或可有助于预测组织学转化风险。

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    2019-09-21 nymo
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