Hiorns L R, Nicholls J, Sloane J P, Horwich A, Ashley S, Brada M
Academic Unit of Radiotherapy and Oncology, Institute of Cancer Research, Sutton, Surrey, UK.
Br J Cancer. 1994 Feb;69(2):347-51. doi: 10.1038/bjc.1994.63.
Peripheral blood from 67 patients with non-Hodgkin's lymphoma was examined at initial diagnosis for the presence of circulating lymphoma cells by DNA hybridisation using immunoglobulin and T-cell receptor gene probes. Clonal gene rearrangement was found in 31% (21/67) of patients and correlated with clinical stage, histological grade and bone marrow involvement. Clinical stage and the presence of lymphoma cells in peripheral blood were prognostic factors for progression-free survival in all patients on univariate analysis, but the detection of lymphoma cells was not independent of stage. It was also not a significant predictor for survival. In patients with intermediate- and high-grade lymphoma, the detection of lymphoma cells in peripheral blood was a significant prognostic factor for progression-free survival (PFS) and survival only on univariate analysis. The 3-year PFS was 17% in patients with circulating lymphoma cells compared with 75% if these were absent (P < 0.05). The presence of lymphoma cells in peripheral blood is associated with extensive disease and may be a biological marker of poor disease control. Sensitive techniques of detection should form part of large prospective studies in non-Hodgkin's lymphoma.
在初次诊断时，采用免疫球蛋白和T细胞受体基因探针，通过DNA杂交技术对67例非霍奇金淋巴瘤患者的外周血进行检测，以确定是否存在循环淋巴瘤细胞。31%（21/67）的患者发现克隆性基因重排，且与临床分期、组织学分级和骨髓受累情况相关。单因素分析显示，临床分期和外周血中淋巴瘤细胞的存在是所有患者无进展生存期的预后因素，但淋巴瘤细胞的检测并不独立于分期，也不是生存的显著预测指标。在中高级别淋巴瘤患者中，外周血中淋巴瘤细胞的检测仅在单因素分析中是无进展生存期（PFS）和生存的显著预后因素。循环淋巴瘤细胞患者的3年无进展生存率为17%，无循环淋巴瘤细胞患者为75%（P<0.05）。外周血中淋巴瘤细胞的存在与广泛病变相关，可能是疾病控制不佳的生物学标志物。敏感的检测技术应成为非霍奇金淋巴瘤大型前瞻性研究的一部分。
