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B细胞非霍奇金淋巴瘤中涉及共济失调毛细血管扩张位点的获得性11号染色体q臂缺失:与临床生物学特征的相关性

Acquired chromosome 11q deletion involving the ataxia teleangiectasia locus in B-cell non-Hodgkin's lymphoma: correlation with clinicobiologic features.

作者信息

Cuneo A, Bigoni R, Rigolin G M, Roberti M G, Milani R, Bardi A, Minotto C, Agostini P, De Angeli C, Narducci M G, Sabbioni S, Russo G, Negrini M, Castoldi G

机构信息

Dipartimento di Scienze Biomediche e Terapie Avanzate, Sezione di Ematologia, Sezione di Microbiologia, University of Ferrara, Ferrara, Italy.

出版信息

J Clin Oncol. 2000 Jul;18(13):2607-14. doi: 10.1200/JCO.2000.18.13.2607.

Abstract

PURPOSE

To study the clinicobiologic significance of acquired 11q deletions involving the ataxia teleangiectasia locus (ATM+/-) in B-cell non-Hodgkin's lymphomas (NHL).

PATIENTS AND METHODS

Fifty-three indolent lymphomas and 82 aggressive lymphomas were studied by conventional cytogenetic analysis and by fluorescence in situ hybridization using an 11q22-23 probe recognizing ATM sequences. Pertinent clinical data were collected.

RESULTS

A hemizygous ATM deletion was seen in 44% to 88% of the interphase cells in 15 cases (11.1%); four patients had an indolent lymphoma (follicular center cell lymphoma), and 11 patients had an aggressive lymphoma (five mantle-cell lymphomas [MCLs] and six diffuse large-cell lymphomas). Dual-color hybridization studies showed ATM deletion to be possibly a secondary aberration in three patients with MCL. Ten out of 15 ATM+/- patients had a complex karyotype, 11 out of 15 had more than 90% abnormal metaphases (AA karyotype status), and +12, 13q14 deletion, and 17p13 deletion were seen in seven, four, and five cases, respectively. Patients with ATM+/- more frequently had a complex karyotype (P =.01) and the AA karyotype (P =.04) compared with patients without ATM+/-. With the exception of a poor performance status (P =.001), no correlation was found between ATM+/-, initial clinical variables, and complete remission rate; whereas a highly significant association was found with shorter survival (P <.0001). This cytogenetic lesion maintained its prognostic importance in multivariate analysis (P =.0004), along with performance status (P =.0006), serum lactate dehydrogenase level (P =.03), splenomegaly (P =.01), and histologic grade (P =.03). When analyzing indolent lymphomas and aggressive lymphomas separately, ATM+/- maintained its prognostic importance as an independent variable in both histologic groups (P =.0001 and P =.016, respectively).

CONCLUSION

Though possibly not representing a primary genetic lesion in the majority of cases, the acquired ATM+/- status has clinicobiologic importance in NHL, possibly representing a major cytogenetic determinant of outcome.

摘要

目的

研究B细胞非霍奇金淋巴瘤(NHL)中涉及共济失调毛细血管扩张症基因座(ATM+/-)的获得性11q缺失的临床生物学意义。

患者与方法

采用常规细胞遗传学分析及使用识别ATM序列的11q22 - 23探针进行荧光原位杂交,对53例惰性淋巴瘤和82例侵袭性淋巴瘤进行研究。收集相关临床数据。

结果

15例患者(11.1%)的间期细胞中44%至88%可见半合子ATM缺失;4例患者为惰性淋巴瘤(滤泡中心细胞淋巴瘤),11例患者为侵袭性淋巴瘤(5例套细胞淋巴瘤[MCL]和6例弥漫大B细胞淋巴瘤)。双色杂交研究显示,3例MCL患者中ATM缺失可能是继发畸变。15例ATM+/-患者中,10例核型复杂,15例中有11例异常中期细胞超过90%(AA核型状态),分别有7例、4例和5例出现+12、13q14缺失和17p13缺失。与无ATM+/-的患者相比,ATM+/-患者核型复杂(P = 0.01)及AA核型(P = 0.04)更为常见。除体能状态差(P = 0.001)外,未发现ATM+/-与初始临床变量及完全缓解率之间存在相关性;但发现其与生存期缩短高度相关(P < 0.0001)。在多变量分析中,该细胞遗传学病变与体能状态(P = 0.0006)、血清乳酸脱氢酶水平(P = 0.03)、脾肿大(P = 0.01)及组织学分级(P = 0.03)一样,保持其预后重要性(P = 0.0004)。分别分析惰性淋巴瘤和侵袭性淋巴瘤时,ATM+/-在两个组织学组中均作为独立变量保持其预后重要性(分别为P = 0.0001和P = 0.016)。

结论

虽然在大多数情况下可能并非主要遗传病变,但获得性ATM+/-状态在NHL中具有临床生物学重要性,可能是影响预后的主要细胞遗传学决定因素。

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