HBV感染DLBCL患者的分子机制及预后研究

Molecular mechanism and prognosis of HBV-infected patients with DLBCL

近年来乙型肝炎病毒(hepatitis B virus,HBV)感染者患弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的概率呈上升趋势,且其病因复杂,治疗棘手,因此受到国内外学者的广泛关注。本文在回顾分析国内外学者研究的基础上,进一步探讨了HBV感染致DLBCL发生、发展的机制及相关患者的临床预后情况,最终发现在基因组、转录组层面,HBV可能主要通过诱导BCL6、FOXO1、ZFP36L1等基因的改变,以及通过HBV的X蛋白激活各种调控基因,从而诱导淋巴细胞克隆性增生,最终形成淋巴瘤;而针对患者的临床预后评估,主要通过分析比较患者发病年龄、性别、脏器受累情况、国际预后指数(IPI)、乳酸脱氢酶(lactate dehydrogenase,LDH)水平、增殖指数(Ki-67)、bcl-2、bcl-6、炎症指标等因素,旨在为DLBCL的临床诊治及基础研究提出理论依据。

In recent years,hepatitis B virus(HBV)-Infected patients with diffuse large B cell lymphoma(DLBCL)have increased.Its etiology is complex and treatment is difficult.Therefore,it has received extensive research attention.By reviewing and analyzing the studies of domestic and foreign researchers,this article discusses the mechanism of the occurrence and development of DLBCL caused by HBV infection and the clinical prognosis of patients.The findings suggest that,at genomic and transcriptome levels,HBV mainly induces changes in the expression of BCL6,FOXO1,ZFP36L1 and other genes,and activate various regulatory genes through the HBV X protein,thereby inducing clonal proliferation of lymphocytes and eventually forming lymphoma.The prognostic assessment mainly analyzes and compares the patient age of onset,sex,organ involvement,international prognostic index,lactate dehydrogenase level,proliferation index(Ki-67),bcl-2,bcl-6,inflammatory index,and other factors,to propose a theoretical basis for clinical diagnosis and treatment of DLBCL and basic research.