Nichols Kim E, Walther Susan, Chao Elizabeth, Shields Carol, Ganguly Arupa
Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Curr Opin Ophthalmol. 2009 Sep;20(5):351-5. doi: 10.1097/ICU.0b013e32832f7f25.
Retinoblastoma is a pediatric eye tumor that serves as a paradigm for understanding the genetic basis of cancer. This review will highlight recent advances in retinoblastoma genetic research and discuss how these new findings influence our knowledge of retinoblastoma tumorigenesis and management.
Current data demonstrate that retinomas, benign retinal tumors found in some retinoblastoma patients, exhibit bi-allelic mutations in RB1, the retinoblastoma gene, and lack of expression of the retinoblastoma protein. Interestingly, retinomas demonstrate a low level of genomic instability that becomes progressively more severe in retinoblastoma tumors. Additionally, a subset of retinomas share genomic alterations with retinoblastoma. Collectively, these data suggest that retinomas represent true premalignant lesions and not regressed retinoblastoma tumors, as previously thought. Translational advances in retinoblastoma genetic research include development of an allele-specific assay that now enables the identification of mutational mosaicism, thereby increasing the rate of RB1 mutation detection in bilaterally affected patients to as high as 95%.
These and related research efforts reveal novel data that enhance our understanding of the biology of retinoblastoma. These observations may facilitate new therapeutic approaches to further decrease the morbidity and mortality associated with retinoblastoma and other more common forms of cancer.
视网膜母细胞瘤是一种儿童眼部肿瘤,是理解癌症遗传基础的范例。本综述将重点介绍视网膜母细胞瘤遗传研究的最新进展,并讨论这些新发现如何影响我们对视网膜母细胞瘤肿瘤发生和治疗的认识。
目前的数据表明,在一些视网膜母细胞瘤患者中发现的良性视网膜肿瘤视网膜瘤,在视网膜母细胞瘤基因RB1中表现出双等位基因突变,且视网膜母细胞瘤蛋白表达缺失。有趣的是,视网膜瘤表现出低水平的基因组不稳定性,在视网膜母细胞瘤肿瘤中这种不稳定性会逐渐变得更加严重。此外,一部分视网膜瘤与视网膜母细胞瘤存在共同的基因组改变。总体而言,这些数据表明视网膜瘤代表真正的癌前病变,而不是如之前所认为的退化的视网膜母细胞瘤肿瘤。视网膜母细胞瘤遗传研究的转化进展包括开发了一种等位基因特异性检测方法,该方法现在能够识别突变嵌合体,从而将双侧受累患者中RB1突变的检测率提高到高达95%。
这些及相关研究工作揭示了新的数据,增强了我们对视网膜母细胞瘤生物学的理解。这些观察结果可能有助于开发新的治疗方法,以进一步降低与视网膜母细胞瘤及其他更常见癌症形式相关的发病率和死亡率。