McCann Katy J, Ashton-Key Margaret, Smith Kellyann, Stevenson Freda K, Ottensmeier Christian H
Translational Immunotherapy Group, Cancer Sciences Division, University of Southampton School of Medicine, Southampton, United Kingdom.
Blood. 2009 May 7;113(19):4677-80. doi: 10.1182/blood-2008-09-179366. Epub 2008 Dec 18.
Primary central nervous system (CNS) lymphoma is an aggressive B-cell tumor that is defined clinically by the absence of systemic disease. We have used immunoglobulin variable (V)-gene analysis to identify tumor cells at the CNS site in 12 cases and to probe the involvement of peripheral tissues in 3 patients. Clonal tracking revealed tumor cells in the bone marrow and/or blood for 3 of 3 cases, with evidence for increased V-gene mutational activity at peripheral sites. In 2 of 3 cases, intraclonal variant analysis revealed identity with the brain biopsy but detected additional variants unique to extracerebral sites. These findings suggest that peripheral tumor cells can undergo separate development locally with no reentry into the brain. Primary CNS lymphoma appears to have both CNS-specific and systemic components with limited interchange. The more malignant behavior of tumor cells in the CNS suggests either a local environmental influence or a less malignant phenotype of the peripheral clone.
原发性中枢神经系统（CNS）淋巴瘤是一种侵袭性B细胞肿瘤，临床上定义为无全身性疾病。我们利用免疫球蛋白可变（V）基因分析，在12例患者的中枢神经系统部位鉴定肿瘤细胞，并对3例患者的外周组织受累情况进行探究。克隆追踪显示，3例患者中有3例在骨髓和/或血液中发现肿瘤细胞，有证据表明外周部位的V基因突变活性增加。在3例患者中的2例中，克隆内变异分析显示与脑活检结果一致，但检测到脑外部位特有的其他变异。这些发现表明，外周肿瘤细胞可在局部独立发展，不再进入大脑。原发性中枢神经系统淋巴瘤似乎具有中枢神经系统特异性和全身性成分，两者之间的互换有限。中枢神经系统中肿瘤细胞更具恶性的行为表明，要么是局部环境影响，要么是外周克隆的恶性表型较低。
