Department of Haematology, Faculté de Médecine de Marseille, Université de la Méditerranée Aix-Marseille 2, Marseille, France.
Br J Haematol. 2010 Jul;150(1):21-7. doi: 10.1111/j.1365-2141.2009.07977.x. Epub 2009 Nov 12.
Peripheral T-cell lymphomas constitute a heterogeneous group with regard to diagnosis, treatment and prognosis. Efforts have been made to combine novel techniques with cytology and immunochemistry in order to more precisely define these entities. Molecular profiling has contributed to novel insights in the biology of T-cell lymphoma. Regarding anaplastic large cell lymphoma, low expression T-cell receptor signalling and high STAT3 target signatures have been associated with the ALK-positive subgroup. Gene expression profiling differentiates angioblastic T-cell lymphoma from other T-cell malignancies, suggests that the normal counterpart of lymphoma cells are follicular helper T cells, and supports the involvement of vascular endothelial growth factor deregulation in its physiopathology. In peripheral T-cell lymphoma unspecified, gene profiling suggests the normal counterpart of tumour cells are activated CD4(+) or CD8(+) T-lymphocytes, delineates prognostic groups depending on the proliferative signature, and suggests therapeutic options aimed at regulating nuclear factor-kappaB and platelet-derived growth factor receptor-alpha phosphorylation. Gene expression profiling of primary cutaneous T cell lymphomas highlighted the importance of abnormal methylation patterns, suggested a pivotal role for JUNB/AP-1, and defined a predictive model for response to interferon-alpha. In conclusion, gene expression profiling is beginning to change the pathological classification, the prognosis profiles and the therapeutic approach in T-cell lymphomas.
外周 T 细胞淋巴瘤在诊断、治疗和预后方面具有异质性。人们努力将新技术与细胞学和免疫化学相结合,以更精确地定义这些实体。分子谱分析为 T 细胞淋巴瘤的生物学提供了新的见解。对于间变性大细胞淋巴瘤,低表达 T 细胞受体信号和高 STAT3 靶标特征与 ALK 阳性亚组相关。基因表达谱分析将血管母细胞瘤性 T 细胞淋巴瘤与其他 T 细胞恶性肿瘤区分开来,提示淋巴瘤细胞的正常对应物是滤泡辅助 T 细胞,并支持血管内皮生长因子失调在其病理生理学中的参与。在外周 T 细胞淋巴瘤未分类中,基因谱分析提示肿瘤细胞的正常对应物是活化的 CD4(+)或 CD8(+)T 淋巴细胞,根据增殖特征划定预后组,并提示针对调节核因子-κB 和血小板衍生生长因子受体-α磷酸化的治疗选择。原发性皮肤 T 细胞淋巴瘤的基因表达谱分析强调了异常甲基化模式的重要性,提示 JUNB/AP-1 具有关键作用,并定义了干扰素-α反应的预测模型。总之,基因表达谱分析开始改变 T 细胞淋巴瘤的病理分类、预后特征和治疗方法。