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精准医学时代的淋巴瘤诊断和治疗的诊断和预测生物标志物。

Diagnostic and predictive biomarkers for lymphoma diagnosis and treatment in the era of precision medicine.

机构信息

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Department of Pathology, Shanxi Cancer Hospital, Shanxi, China.

出版信息

Mod Pathol. 2016 Oct;29(10):1118-42. doi: 10.1038/modpathol.2016.92. Epub 2016 Aug 1.

Abstract

Lymphomas are a group of hematological malignancies derived from lymphocytes. Lymphomas are clinically and biologically heterogeneous and have overlapping diagnostic features. With the advance of new technologies and the application of efficient and feasible detection platforms, an unprecedented number of novel biomarkers have been discovered or are under investigation at the genetic, epigenetic, and protein level as well as the tumor microenvironment. These biomarkers have enabled new clinical and pathological insights into the mechanisms underlying lymphomagenesis and also have facilitated improvements in the diagnostic workup, sub-classification, outcome stratification, and personalized therapy for lymphoma patients. However, integrating these biomarkers into clinical practice effectively and precisely in daily practice is challenging. More in-depth studies are required to further validate these novel biomarkers and to assess other parameters that can affect the reproducibility of these biomarkers such as the selection of detection methods, biological reagents, interpretation of data, and cost efficiency. Despite these challenges, there are many reasons to be optimistic that novel biomarkers will facilitate better algorithms and strategies as we enter a new era of precision medicine to better refine diagnosis, prognostication, and rational treatment design for patients with lymphomas.

摘要

淋巴瘤是一组起源于淋巴细胞的血液系统恶性肿瘤。淋巴瘤在临床上和生物学上具有异质性,并且具有重叠的诊断特征。随着新技术的进步和高效可行的检测平台的应用,在遗传、表观遗传和蛋白质水平以及肿瘤微环境方面,已经发现或正在研究大量新的生物标志物。这些生物标志物使人们对淋巴瘤发生的机制有了新的临床和病理认识,并有助于改进淋巴瘤患者的诊断评估、亚分类、预后分层和个体化治疗。然而,在日常实践中有效地、准确地将这些生物标志物整合到临床实践中是具有挑战性的。需要进一步深入研究来进一步验证这些新型生物标志物,并评估其他可能影响这些生物标志物重现性的参数,如检测方法、生物试剂、数据解释和成本效益的选择。尽管存在这些挑战,但有很多理由让人乐观地认为,新型生物标志物将有助于在我们进入精准医学的新时代时制定出更好的算法和策略,从而更好地细化对淋巴瘤患者的诊断、预后和合理治疗设计。

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