目的探讨睾丸原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中MyD88及CD79B基因突变及意义。方法回顾性分析15例睾丸原发性DLBCL的临床病理学特点,采用免疫组化及Sanger测序法检测原发性DLBCL中MyD88及CD79 B基因突变...目的探讨睾丸原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中MyD88及CD79B基因突变及意义。方法回顾性分析15例睾丸原发性DLBCL的临床病理学特点,采用免疫组化及Sanger测序法检测原发性DLBCL中MyD88及CD79 B基因突变,分析MyD88及CD79B基因突变与肿瘤临床病理学特点、NF-κB蛋白在细胞核表达之间的关系。结果免疫组化显示15例DLBCL均为非生发中心B(non germinal center B,non-GCB)细胞型,4例存在CD79B基因Y196位点突变(26.7%),7例存在MyD88基因L265位点突变(46.7%),3例同时存在CD79B及MyD88基因突变(20%)。8例患者获得随访,未发现CD79B及MyD88基因突变与预后的相关性。结论中国人睾丸原发性DLBCL中存在较高的CD79B基因Y196位点和(或)MyD88基因L265位点突变,为针对这些突变基因的分子靶向治疗提供依据。展开更多
目的探讨弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)中MYD88、CD79B基因突变与其临床病理特征及预后的相关性。方法对2016年10月~2020年7月苏州大学附属第三医院89例经病理学诊断的DLBCL进行回顾性分析。应用二代测序技...目的探讨弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)中MYD88、CD79B基因突变与其临床病理特征及预后的相关性。方法对2016年10月~2020年7月苏州大学附属第三医院89例经病理学诊断的DLBCL进行回顾性分析。应用二代测序技术检测患者基因变异情况,并分析MYD88、CD79B基因与临床病理特征及预后的关系。结果89例DLBCL中MYD88基因突变、CD79B基因突变和MYD88/CD79B基因双突变的频率分别为20.2%、21.3%、6.7%。MYD88基因在非生发中心B细胞(non-germinal center B-cell-like,non-GCB)型、BCL-2阳性、c-MYC/BCL-2双阳性和Ki-67增殖指数高的病例中具有较高的突变频率(P<0.05)。CD79B基因在non-GCB型及Ki-67增殖指数高的病例中具有较高的突变频率(P<0.05)。MYD88/CD79B基因双突变在c-MYC/BCL-2双阳性及Ki-67增殖指数高的病例中具有较高的突变频率(P<0.05)。MYD88基因突变和MYD88/CD79B基因双突变病例在中期疗效评估时其完全缓解率均低于非突变病例(P<0.05)。单因素Kaplan-Meier生存分析显示:MYD88基因突变和MYD88/CD79B基因双突变患者的总生存期及无进展生存期均低于非突变组(P<0.05)。结论MYD88基因突变DLBCL更常见于non-GCB型,具有较高的Ki-67增殖指数、BCL-2阳性和c-MYC/BCL-2共阳性的特点;CD79B基因突变DLBCL更常见于non-GCB型,Ki-67增殖指数较高;MYD88/CD79B基因双突变DLBCL具有较高的Ki-67增殖指数和c-MYC/BCL-2共阳性的特点。MYD88基因突变、MYD88/CD79B基因双突变影响DLBCL患者化疗效果及长期生存。展开更多
BACKGROUNDOver the past 20 years,we have gained a deep understanding of the biologicalheterogeneity of diffuse large B cell lymphoma(DLBCL)and have developed arange of new treatment programs based on the characteristi...BACKGROUNDOver the past 20 years,we have gained a deep understanding of the biologicalheterogeneity of diffuse large B cell lymphoma(DLBCL)and have developed arange of new treatment programs based on the characteristics of the disease,bringing us to the era of immune-chemotherapy.However,the effectiveness andmolecular mechanisms of targeted-immunotherapy remain unclear in DLBCL.Targeted-immunotherapy may be beneficial for specific subgroups of patients,thus requiring biomarker assessment.CASE SUMMARYHere,we report a case of MCD subtype DLBCL with MYD88L265P and CD79Bmutations,considered in the initial stage as lymphoplasmic lymphoma(LPL)orWaldenstrom macroglobulinemia(WM).Flow cytometry supported this view;however,the immunohistochemical results of the lymph nodes overturned theabove diagnosis,and the patient was eventually diagnosed with MCD subtypeDLBCL.The presence of a monoclonal IgM component in the serum and infiltrationof small lymphocytes with a phenotype compatible with WM into the bonemarrow led us to propose a hypothesis that the case we report may have transformedfrom LPL/WM.CONCLUSIONThis highlights the possible transformation from WM to DLBCL,CD79B mutationmay be a potential biomarker for predicting this conversion.展开更多
文摘目的探讨睾丸原发性弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)中MyD88及CD79B基因突变及意义。方法回顾性分析15例睾丸原发性DLBCL的临床病理学特点,采用免疫组化及Sanger测序法检测原发性DLBCL中MyD88及CD79 B基因突变,分析MyD88及CD79B基因突变与肿瘤临床病理学特点、NF-κB蛋白在细胞核表达之间的关系。结果免疫组化显示15例DLBCL均为非生发中心B(non germinal center B,non-GCB)细胞型,4例存在CD79B基因Y196位点突变(26.7%),7例存在MyD88基因L265位点突变(46.7%),3例同时存在CD79B及MyD88基因突变(20%)。8例患者获得随访,未发现CD79B及MyD88基因突变与预后的相关性。结论中国人睾丸原发性DLBCL中存在较高的CD79B基因Y196位点和(或)MyD88基因L265位点突变,为针对这些突变基因的分子靶向治疗提供依据。
文摘目的探讨弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)中MYD88、CD79B基因突变与其临床病理特征及预后的相关性。方法对2016年10月~2020年7月苏州大学附属第三医院89例经病理学诊断的DLBCL进行回顾性分析。应用二代测序技术检测患者基因变异情况,并分析MYD88、CD79B基因与临床病理特征及预后的关系。结果89例DLBCL中MYD88基因突变、CD79B基因突变和MYD88/CD79B基因双突变的频率分别为20.2%、21.3%、6.7%。MYD88基因在非生发中心B细胞(non-germinal center B-cell-like,non-GCB)型、BCL-2阳性、c-MYC/BCL-2双阳性和Ki-67增殖指数高的病例中具有较高的突变频率(P<0.05)。CD79B基因在non-GCB型及Ki-67增殖指数高的病例中具有较高的突变频率(P<0.05)。MYD88/CD79B基因双突变在c-MYC/BCL-2双阳性及Ki-67增殖指数高的病例中具有较高的突变频率(P<0.05)。MYD88基因突变和MYD88/CD79B基因双突变病例在中期疗效评估时其完全缓解率均低于非突变病例(P<0.05)。单因素Kaplan-Meier生存分析显示:MYD88基因突变和MYD88/CD79B基因双突变患者的总生存期及无进展生存期均低于非突变组(P<0.05)。结论MYD88基因突变DLBCL更常见于non-GCB型,具有较高的Ki-67增殖指数、BCL-2阳性和c-MYC/BCL-2共阳性的特点;CD79B基因突变DLBCL更常见于non-GCB型,Ki-67增殖指数较高;MYD88/CD79B基因双突变DLBCL具有较高的Ki-67增殖指数和c-MYC/BCL-2共阳性的特点。MYD88基因突变、MYD88/CD79B基因双突变影响DLBCL患者化疗效果及长期生存。
文摘BACKGROUNDOver the past 20 years,we have gained a deep understanding of the biologicalheterogeneity of diffuse large B cell lymphoma(DLBCL)and have developed arange of new treatment programs based on the characteristics of the disease,bringing us to the era of immune-chemotherapy.However,the effectiveness andmolecular mechanisms of targeted-immunotherapy remain unclear in DLBCL.Targeted-immunotherapy may be beneficial for specific subgroups of patients,thus requiring biomarker assessment.CASE SUMMARYHere,we report a case of MCD subtype DLBCL with MYD88L265P and CD79Bmutations,considered in the initial stage as lymphoplasmic lymphoma(LPL)orWaldenstrom macroglobulinemia(WM).Flow cytometry supported this view;however,the immunohistochemical results of the lymph nodes overturned theabove diagnosis,and the patient was eventually diagnosed with MCD subtypeDLBCL.The presence of a monoclonal IgM component in the serum and infiltrationof small lymphocytes with a phenotype compatible with WM into the bonemarrow led us to propose a hypothesis that the case we report may have transformedfrom LPL/WM.CONCLUSIONThis highlights the possible transformation from WM to DLBCL,CD79B mutationmay be a potential biomarker for predicting this conversion.
