Castoldi G, Cuneo A, Lanza F
Istituto di Ematologia, Università, Ferrara.
Recenti Prog Med. 1992 Mar;83(3):178-83.
Recent advances in immunology, cytogenetics and molecular genetics has allowed for a better understanding of the origin and evolution of non Hodgkin lymphoma (NHL). Over the last decade a number of recurrent chromosome aberrations has been disclosed and some correlations with well defined histologic subsets of B-cell NHL has been established. Five important cytogenetic-histologic associations has been documented, well defined by combined cytologic, immunologic and genetic investigations: t(14;18) (q32;q21) and NHL of follicle centre cell origin, frequently with follicular histologic pattern; t(8;14) (q24;q32) and Burkitt's lymphoma, Burkitt-like lymphoma or the equivalent small non-cleaved cell category of the "working formulation system"; t(3;22) (q27;q11) and diffuse large cell lymphoma; t(11;14) (q13;q32) and mantle zone lymphoma; trisomy 12 and chronic lymphocytic leukemia and well-differentiated small lymphocytic lymphoma. Molecular genetic studies elucidated some mechanisms operating during the normal lymphocyte differentiation which may be held responsible for the illegitimate recombination between the immunoglobulin genes and some oncogenes normally located on other chromosome regions. It has thus been demonstrated that the early events leading to neoplastic transformation in B-cell neoplasias occur in immature lymphocyte precursors in the bone marrow during the assembly of the immunoglobulin heavy chain gene. According to some recent studies chromosome changes may have prognostic value in B-cell NHL and chronic lymphocytic leukemia and may be employed in clinical practice in the construction of proportional hazard models in several histologic subsets of NHL.
免疫学、细胞遗传学和分子遗传学领域的最新进展,使人们对非霍奇金淋巴瘤(NHL)的起源和演变有了更好的理解。在过去十年中,已发现了一些常见的染色体畸变,并建立了其中一些畸变与B细胞NHL明确的组织学亚组之间的关联。已记录了五个重要的细胞遗传学-组织学关联,通过细胞学、免疫学和遗传学联合研究得到了明确界定:t(14;18)(q32;q21)与滤泡中心细胞起源的NHL相关,常具有滤泡组织学模式;t(8;14)(q24;q32)与伯基特淋巴瘤、伯基特样淋巴瘤或“工作分类系统”中的等效小无裂细胞类别相关;t(3;22)(q27;q11)与弥漫性大细胞淋巴瘤相关;t(11;14)(q13;q32)与套细胞淋巴瘤相关;12号染色体三体与慢性淋巴细胞白血病和高分化小淋巴细胞淋巴瘤相关。分子遗传学研究阐明了正常淋巴细胞分化过程中起作用的一些机制,这些机制可能导致免疫球蛋白基因与通常位于其他染色体区域的一些癌基因之间发生异常重组。因此已证明,B细胞肿瘤形成中导致肿瘤转化的早期事件发生在骨髓中未成熟淋巴细胞前体在免疫球蛋白重链基因组装过程中。根据最近的一些研究,染色体变化在B细胞NHL和慢性淋巴细胞白血病中可能具有预后价值,并可用于临床实践,在NHL的几个组织学亚组中构建比例风险模型。