Servicio de Oncología Médica, Grupo de Investigación en Linfomas, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHISA, Madrid, Spain.
Grupo Oncológico para el Tratamiento y Estudio de los Linfomas-GOTEL, Madrid, Spain.
Clin Transl Oncol. 2024 May;26(5):1043-1062. doi: 10.1007/s12094-023-03307-1. Epub 2023 Sep 6.
The new lymphoma classifications (International Consensus Classification of Mature Lymphoid Neoplasms, and 5th World Health Organization Classification of Lymphoid Neoplasms) include genetics as an integral part of lymphoma diagnosis, allowing better lymphoma subclassification, patient risk stratification, and prediction of treatment response. Lymphomas are characterized by very few recurrent and disease-specific mutations, and most entities have a heterogenous genetic landscape with a long tail of recurrently mutated genes. Most of these occur at low frequencies, reflecting the clinical heterogeneity of lymphomas. Multiple studies have identified genetic markers that improve diagnostics and prognostication, and next-generation sequencing is becoming an essential tool in the clinical laboratory. This review provides a "next-generation sequencing" guide for lymphomas. It discusses the genetic alterations of the most frequent mature lymphoma entities with diagnostic, prognostic, and predictive potential and proposes targeted sequencing panels to detect mutations and copy-number alterations for B- and NK/T-cell lymphomas.
新的淋巴瘤分类(成熟淋巴细胞肿瘤国际共识分类和第五版世界卫生组织淋巴肿瘤分类)将遗传学作为淋巴瘤诊断的一个组成部分,从而能够更好地对淋巴瘤进行亚分类、对患者进行风险分层和预测治疗反应。淋巴瘤的特征是很少有复发和疾病特异性突变,大多数实体具有异质性的遗传景观,存在大量反复突变的基因。大多数这些基因的突变频率较低,反映了淋巴瘤的临床异质性。多项研究已经确定了可改善诊断和预后的遗传标志物,下一代测序正在成为临床实验室的重要工具。本综述为淋巴瘤提供了一份“下一代测序”指南。它讨论了具有诊断、预后和预测潜力的最常见成熟淋巴瘤实体的遗传改变,并提出了针对 B 细胞和 NK/T 细胞淋巴瘤的靶向测序panel,以检测突变和拷贝数改变。