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伴有核磷蛋白(NPM1)突变的急性髓系白血病:分子、病理及临床特征

Acute myeloid leukemia with mutated nucleophosmin (NPM1): molecular, pathological, and clinical features.

作者信息

Falini Brunangelo

机构信息

Institute of Hematology, University of Perugia, Perugia, Italy.

出版信息

Cancer Treat Res. 2010;145:149-68. doi: 10.1007/978-0-387-69259-3_9.

Abstract

The NPM1 gene encodes for nucleophosmin, a nucleolus-located shuttling protein that is involved in multiple cell functions, including regulation of ribosome biogenesis, control of centrosome duplication and preservation of ARF tumor suppressor integrity. The NPM1 gene is specifically mutated in about 30% acute myeloid leukemia (AML) but not in other human neoplasms. Mutations cause crucial changes at the C-terminus of the NPM1 protein that are responsible for the aberrant nuclear export and accumulation of NPM1 mutants in the cytoplasm of leukemic cells. Diagnosis of AML with mutated NPM1 can be done using molecular techniques, immunohistochemistry (looking at cytoplasmic dislocation of nucleophosmin that is predictive of NPM1 mutations) and Western blotting with antibodies specifically directed against NPM1 mutants. Because of its distinctive molecular, pathological, immunophenotypic and prognostic features, AML with mutated NPM1 (synonym: NPMc+ AML) has been included, as a new provisional entity, in the 2008 World Health Organization (WHO) classification of myeloid neoplasms.

摘要

NPM1基因编码核磷蛋白,一种定位于核仁的穿梭蛋白,参与多种细胞功能,包括核糖体生物合成的调节、中心体复制的控制以及ARF肿瘤抑制因子完整性的维持。NPM1基因在约30%的急性髓系白血病(AML)中发生特异性突变,但在其他人类肿瘤中未发生突变。突变导致NPM1蛋白C末端发生关键变化,这是白血病细胞胞质中NPM1突变体异常核输出和积累的原因。可使用分子技术、免疫组织化学(观察核磷蛋白的胞质移位,这可预测NPM1突变)以及用特异性针对NPM1突变体的抗体进行蛋白质印迹法来诊断NPM1突变的AML。由于其独特的分子、病理、免疫表型和预后特征,NPM1突变的AML(同义词:NPMc+ AML)作为一个新的临时实体,已被纳入2008年世界卫生组织(WHO)髓系肿瘤分类中。

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