免疫球蛋白基因体细胞高突变对慢性淋巴细胞白血病预后的影响

Impact of Immunoglobulin Gene Somatic High Mutation on Prognosis of the Chronic Lymphocytic Leukemia——Review

慢性淋巴细胞白血病的临床过程和与预后会有很大区别,精确诊断对判断预后、指导治疗及发病机制的研究均具有非常重要的意义。免疫球蛋白重链可变区(IgHV)突变是目前预测病情最稳定的分子指标。通常IgHV基因序列体细胞高突变者较无突变者预后较好,总体生存期长。最近的研究发现,在一些病例中无论突变与否,特定IgHV基因的表达也能预测疾病结果。CLL患者的临床预后还可根据特定IgHV基因表达被进一步的分层。本文对特定IgHV基因片段在慢性淋巴细胞白血病中表达的临床意义的国内外的研究现状作一综述。

There are great differences in the clinical process and prognosis of the chronic lymphocytic leukemia （CLL） ,the precise diagnosis is of importance to judge prognosis, guide therapy and research pathogenesis mechanism. The variable region mutation of immunoglobulin heavy chain is the most stable molecular index of disease prediction. The patients with sequence of IgHV somatic high mutation usually have a better prognosis and a more longer survival time than those without the mutation. The recent study has found that specific IgHV gene expression also can predict the disease outcome in some Cases regardless of mutation. The clinical prognosis of CLL patients can be further stratified by specific IgHV gene expression. In this review, the progress in the research of the clinical significance of specific IgHV gene expression in the chronic lymphocytic leukemia is summarized.