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接受低剂量重组白细胞介素-2免疫疗法的肾细胞癌患者的细胞遗传学研究。

Cytogenetic studies in renal cell carcinoma patients receiving low-dose recombinant interleukin-2-based immunotherapy.

作者信息

Duensing S, van den Berg-de Ruiter E, Störkel S, Kirchner H, Hänninen E L, Buer J, Poliwoda H, Atzpodien J

机构信息

Division of Hematology, Medizinische Hochschule, Hannover, Germany.

出版信息

Tumour Biol. 1996;17(1):27-33. doi: 10.1159/000217964.

Abstract

A variety of cytogenetic aberrations have been reported in sporadic and familial renal cell carcinoma. Rearrangements of the short arm of chromosome 3 (3p), trisomy 17, and nuclear hyperdiploidy have been reported to be common clonal chromosome changes. We analyzed a total of ten tumor-derived cell lines from patients who underwent nephrectomy for renal cell carcinoma employing conventional cytogenetics. All patients received an immunomodulatory therapy based on recombinant interleukin-2 (rIL-2). Tumor stage and grade, histo- and cytopathology, and patients' response to immunotherapy were assessed and correlated statistically to rearrangement of 3p, trisomy 17, and nuclear hyperdiploidy. Trisomy 17 as clonal aberration could be revealed only in papillary renal cell carcinoma, whereas tumors with compact or tubulopapillary growth pattern lacked this abnormality (p < 0.002). One of 3 patients with diploid or near-diploid karyotype (< or = 49 chromosomes) achieved a partial remission while two presented with stable disease after immunotherapy. In contrast, all 6 patients with tumor progression upon rIL-2-based immunotherapy revealed hyperdiploid (> 49 chromosomes) karyotypes. The correlation between hyperdiploidy and tumor progression was found to be statistically significant (p < 0.029). Interestingly, the only patient achieving an objective tumor remission after immunotherapy presented with a normal diploid karyotype. Our findings suggest tumor hyperdiploidy as an adverse prognostic factor in renal cell carcinoma patients receiving rIL-2-based immunotherapy.

摘要

在散发性和家族性肾细胞癌中已报道了多种细胞遗传学异常。据报道,3号染色体短臂(3p)重排、17号染色体三体性和核超二倍体是常见的克隆性染色体改变。我们采用传统细胞遗传学方法分析了总共10例因肾细胞癌接受肾切除术患者的肿瘤来源细胞系。所有患者均接受基于重组白细胞介素-2(rIL-2)的免疫调节治疗。评估肿瘤分期和分级、组织学和细胞病理学以及患者对免疫治疗的反应,并与3p重排、17号染色体三体性和核超二倍体进行统计学相关性分析。仅在乳头状肾细胞癌中可发现17号染色体三体性作为克隆性异常,而具有致密或管状乳头状生长模式的肿瘤则无此异常(p < 0.002)。3例二倍体或近二倍体核型(≤49条染色体)患者中有1例在免疫治疗后获得部分缓解,2例病情稳定。相比之下,所有6例基于rIL-2的免疫治疗后肿瘤进展的患者均显示超二倍体(> 49条染色体)核型。发现超二倍体与肿瘤进展之间的相关性具有统计学意义(p < 0.029)。有趣的是,免疫治疗后唯一达到客观肿瘤缓解的患者表现为正常二倍体核型。我们的研究结果表明,肿瘤超二倍体是接受基于rIL-2的免疫治疗的肾细胞癌患者的不良预后因素。

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