Lillington Debra M, Kingston Judith E, Coen Pietro G, Price Elizabeth, Hungerford John, Domizio Paola, Young Bryan D, Onadim Zerrin
Department of Medical Oncology, St Bartholomew's Hospital Medical College and the Royal London NHS Trust, London, United Kingdom.
Genes Chromosomes Cancer. 2003 Feb;36(2):121-8. doi: 10.1002/gcc.10149.
Forty-nine primary retinoblastoma (Rb) tumors were analyzed by the use of comparative genomic hybridization (CGH), and clinical/histological correlations were performed. Adverse histological factors were present in 13 patients. Chromosomal imbalance was a frequent phenomenon, seen in 96% of the tumors. Gain of 6p represented the most frequent event (69% of the tumors), whereas +1q was observed in 57%, confirming that these abnormalities are key secondary events in retinoblastoma tumor progression. Loss of 13q and 16 was significantly associated with tumors displaying adverse histo-prognostic factors, whereas -16q was significantly associated with tumors without adverse features. In three patients who developed an extra-ocular relapse, the tumors showed -13q and 2/3 had -5q, suggesting that these abnormalities may be associated with metastasis. Children >or= 36 months of age at enucleation tended to have more CGH abnormalities per tumor than children < 12 months (median numbers 11 vs. 3). In addition, +1q, +13q, -16, and -16q were more frequent in children with an older age at enucleation. Identical CGH changes were found in both tumors from one patient with bilateral tumors, suggesting a common origin. It is possible that tumors displaying loss of 13q and 5q indicate those patients who may suffer an adverse outcome and who would require alternative or more intensive therapy. CGH analysis on larger cohorts and in prospective clinical trials will be invaluable in determining whether a genetic classification of retinoblastoma represents a reliable measure of prognosis.
采用比较基因组杂交(CGH)技术分析了49例原发性视网膜母细胞瘤(Rb)肿瘤,并进行了临床/组织学相关性分析。13例患者存在不良组织学因素。染色体失衡是一种常见现象,在96%的肿瘤中可见。6p的增加是最常见的事件(占肿瘤的69%),而+1q在57%的肿瘤中被观察到,证实这些异常是视网膜母细胞瘤肿瘤进展中的关键继发性事件。13q和16的缺失与显示不良组织学预后因素的肿瘤显著相关,而-16q与无不良特征的肿瘤显著相关。在3例发生眼外复发的患者中,肿瘤显示-13q,2/3有-5q,提示这些异常可能与转移有关。眼球摘除时年龄≥36个月的儿童每肿瘤的CGH异常往往比年龄<12个月的儿童更多(中位数分别为11和3)。此外,+1q、+13q、-16和-16q在眼球摘除时年龄较大的儿童中更常见。在1例双侧肿瘤患者的两个肿瘤中发现了相同的CGH变化,提示有共同起源。显示13q和5q缺失的肿瘤可能表明那些可能预后不良且需要替代或更强化治疗的患者。对更大队列进行CGH分析以及开展前瞻性临床试验对于确定视网膜母细胞瘤的基因分类是否代表可靠的预后指标将具有重要价值。