Glas Annuska M, Kersten Marie José, Delahaye Leonie J M J, Witteveen Anke T, Kibbelaar Robby E, Velds Arno, Wessels Lodewyk F A, Joosten Peter, Kerkhoven Ron M, Bernards René, van Krieken Johan H J M, Kluin Philip M, van't Veer Laura J, de Jong Daphne
Netherlands Cancer Institute, Division of Diagnostic Oncology, Central Microarray Facility, Amsterdam, The Netherlands.
Blood. 2005 Jan 1;105(1):301-7. doi: 10.1182/blood-2004-06-2298. Epub 2004 Sep 2.
Follicular lymphoma (FL) is a disease characterized by a long clinical course marked by frequent relapses that vary in clinical aggressiveness over time. Therefore, the main dilemma at each relapse is the choice for the most effective treatment for optimal disease control and failure-free survival while at the same time avoiding overtreatment and harmful side effects. The selection for more aggressive treatment is currently based on histologic grading and clinical criteria; however, in up to 30% of all cases these methods prove to be insufficient. Using supervised classification on a training set of paired samples from patients who experienced either an indolent or aggressive disease course, a gene expression profile of 81 genes was established that could, with an accuracy of 100%, distinguish low-grade from high-grade disease. This profile accurately classified 93% of the FL samples in an independent validation set. Most important, in a third series of FL cases where histologic grading was ambiguous, precluding meaningful morphologic guidance, the 81-gene profile shows a classification accuracy of 94%. The FL stratification profile is a more reliable marker of clinical behavior than the currently used histologic grading and clinical criteria and may provide an important alternative to guide the choice of therapy in patients with FL both at presentation and at relapse.
滤泡性淋巴瘤（FL）是一种临床病程较长的疾病，其特点是频繁复发，且随着时间推移临床侵袭性有所不同。因此，每次复发时的主要困境在于选择最有效的治疗方法，以实现最佳的疾病控制和无病生存期，同时避免过度治疗和有害的副作用。目前，更积极治疗的选择基于组织学分级和临床标准；然而，在所有病例中，高达30%的情况证明这些方法并不充分。通过对经历惰性或侵袭性病程的患者的配对样本训练集进行监督分类，建立了一个由81个基因组成的基因表达谱，该谱能够以100%的准确率区分低级别和高级别疾病。在一个独立验证集中，该谱对93%的FL样本进行了准确分类。最重要的是，在第三组组织学分级不明确、无法提供有意义的形态学指导的FL病例中，81基因谱的分类准确率为94%。与目前使用的组织学分级和临床标准相比，FL分层谱是更可靠的临床行为标志物，可能为指导初诊和复发的FL患者的治疗选择提供重要的替代方法。
