淋巴瘤,大细胞,弥漫型

摘要： As one of second-generation of immune modulator agents,lenalidomide has a complex mechanism of action that involves immune regulation,direct anti-tumor,anti-angiogenesis,modulation of the tumor microenvironment,and so on.Compared with thalidomide,lenalidomide has better treatment effect and less adverse reactions,such as neuropathy,somnolence,constipation and so on.Lenalidomide has been approved by the United States Food and Drug Administration for the treatment of multiple myeloma and myelodysplastic syndromes.In recent years,an increasing number of clinical studies have shown that lenalidomide applied in the treatment of diffuse large B-cell lymphoma is also effective.Either lenalidomideor monotherapy or combined with chemotherapy for previously untreated and relapsed/refractory diffuse large B-cell can achieve a certain effect.%来那度胺作为第二代免疫调节剂,具有免疫调节、抗肿瘤、抗血管生成、调节肿瘤微环境等多重作用,其疗效优于沙利度胺,而神经病变、嗜睡、便秘等不良反应明显减轻,现已被美国食品和药物管理局批准用于治疗多发性骨髓瘤和骨髓增生异常综合征.近年来越来越多的临床研究表明来那度胺对于弥漫大B细胞淋巴瘤也有效,其单药应用或联合化疗对初治及复发难治性弥漫大B细胞亦显示出一定的疗效.

摘要： 目的 探讨外周T细胞淋巴瘤(PTCL)继发弥漫大B细胞淋巴瘤(DLBCL)的诊治方法.方法 报道1例PTCL继发DLBCL病例的诊治经过,分析该例患者的临床特点、治疗反应,复习文献探讨该类疾病的机制及预后.结果 患者诊断PTCL非特指型(PTCL-NOS)明确,治疗后出现以EB病毒(EBV)阴性DLBCL为表现的第二肿瘤,其临床特点及发病间隔与之前国外报道类似,可能涉及肿瘤细胞、微环境及治疗等多方面因素.该例患者初步治疗有效,有待进一步随访观察.结论 PTCL-NOS继发EBV阴性DLBCL非常罕见,发病机制和治疗效果有待进一步探索.%Objective To investigate the diagnosis and treatment of sequential diffuse large B-cell lymphoma (DLBCL) after peripheral T-cell lymphoma (PTCL).Methods A case with sequential DLBCL after PTCL was reported,and the characteristics and responses of this case were analyzed.The previous literature was reviewed in order to explain the mechanism and prognosis of such type of disease.Results This patient was diagnosed as PTCL not otherwise specified (PTCL-NOS) definitely,but after a period of treatment,DLBCL was developed as a second tumor.The characteristics and onset interval were just similar to those described in the literature,in which the mechanisms were mentioned as common effects of tumor cell,microenviroment and therapies.This patient got effects through the initial treatment,but considering the poor outcome by former researchers,the prognosis needed to be closely followed up.Conclusion Sequential development of EBV-unrelated DLBCL after PTCL-NOS is very rare,and the mechanism,therapy and prognosis need further investigation.

摘要： Objective To investigate the clinical and pathological features of primary central nervous system diffuse large B-cell lymphoma ( PCNS-DLBCL) , and to investigate survival situation.Methods We got 30 cases of tissue speci-men by surgical resection from PCNS-DLBCL patients, then observed pathological characteristics and immune phenotype by using EnVision two steps and HE staining.Univariate analysis was used to detect the relationships between prognosis and the features including age, PS score, IPI score, treatment and immune subtype.The Cox regression model analysis was used to analyze multivariate influence factors.Results The clinical manifestations were mainly intracranial high pressure and focal neurological deficits.Tumor cells mostly were centroblasts in morphology.The immune phenotype was mainly non-GCB type.Univariate analysis showed that the age, PS score, IPI score, treatment and immune subtype were statisti-cally related to the prognosis of patients (all P<0.05).Multivariate analysis showed that IPI score which was more than 2 was related to poor prognosis (P<0.05).Conclusions The clinical manifestations of PCNS-DLBCL were nonspecific, the long-term survival rate was low and the prognosis was poor.The IPI score was related to the prognosis of patients.%目的：探讨原发中枢神经系统弥漫大B细胞淋巴瘤（ PCNS-DLBCL）患者的临床病理特征及预后情况。方法选择手术切除的PCNS-DLBCL组织30份，采用HE染色及EnVision二步法观察PCNS-DLBCL组织病理学特征和免疫表型特征；单因素分析患者发病年龄、国际预后指数（ IPI）评分、体能状态（ PS）评分、治疗方式、免疫表型与预后的关系，并采用COX回归模型对影响患者预后的因素进行多因素分析。结果 PCNS-DLBCL患者的临床表现以颅内压升高、局灶性神经功能缺损为主；形态学以中心母细胞型为主；免疫表型以non-GCB型为主。单因素分析显示，发病年龄、IPI评分、PS评分、治疗方式、免疫表型与患者预后有关（P均＜0．05）；多因素分析显示， IPI评分≥2分与预后相关（ P＜0．05）。结论 PCNS-DLBCL临床表现无特异性，患者长期生存率低，预后较差；IPI评分与患者预后有关。

摘要： 弥漫大B细胞淋巴瘤(DLBCL)是一种异质性很大的非霍奇金淋巴瘤,其中同时伴有myc和bcl-2重排(或bcl-6重排)者是一种较少见的类型,被称作二次打击淋巴瘤.其临床表现为明显的侵袭性、对化疗耐药、预后极差,成为近年来研究的热点.文章探讨了伴有二次打击的DLBCL重排基因的功能、临床特征、诊断及治疗.%Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of non-Hodgkin's lymphoma.An uncommon subset with myc and either bcl-2 or bcl-6 rearrangement,also known as ‘double-hit’ lymphomas,is considered very aggressive clinical course and poor prognosis despite high-intensity chemotherapy.Recently,these lymphomas have received increased attention.This review explores the existing literatures for the involved genes with their functions,clinical features,diagnosis and treatment.

摘要： 目的 探讨老年人EB病毒阳性(EBV+)弥漫大B细胞淋巴瘤(DLBCL)的临床病理学特点及预后.方法 采用回顾性研究的方法 ,收集24例老年EBV+DLBCL患者,以同期EBV-非特指型DLBCL患者为对照,分析老年EBV+ DLBCL患者的临床病理学特点及预后.结果 24例老年EBV+DLBCL患者肿瘤细胞形态上主要表现为单一性或多形性肿瘤细胞增生;多形性病例中常可见有地图状坏死.细胞起源免疫分型主要为非生发中心亚型,分别占91.3％(Hans分型)和100.0％(Choi分型).CD30阳性率为55.0％,高于非特指型EBV-DLBCL(P＜ 0.001).在总体生存时间方面,R-CHOP方案治疗的老年EBV+DLBCL患者和＞50岁EBV-DLBCL患者的中位生存时间分别为44.2个月和29.2个月,两者差异无统计学意义(P=0.587).结论 老年人EBV+DLBCL肿瘤细胞形态上主要表现为单一性或多形性肿瘤性增生;多形性病例中常可见不规则坏死.CD30阳性率较高,并且主要为非生发中心B细胞亚型.R-CHOP方案治疗的老年EBV+ DLBCL患者的总体生存时间与同年龄段非特指型EBV-DLBCL患者相近.%Objective To analyze the clinical pathological characteristics and prognosis of elderly patients with EB virus-positive diffuse large B-cell lymphoma (EBV+ DLBCL).Methods 24 elderly patients with EBV + DLBCL were collected to evaluate their clinical pathological characteristics and prognosis by comparison with the EBV-DLBCL,NOS during the same period.Results 24 EBV + DLBCL cases demonstrated two morphologic subtypes:polymorphic and monomorphic.And polymorphic subtype showed geographic necrosis more frequently than that in monomorphic subtype.According to Hans and Choi models,the majority of EBV+ DLBCL of the elderly were classified as non-GCB subtype (91.3 ％ and 100.0 ％,respectively).55.0 ％ cases showed CD30 positive,which was significantly higher than that in EBV-DLBCL group (P ＜ 0.001).Under the treatment of R-CHOP regimen,the overall survival (OS) of the elderly EBV+ DLBCL patients showed no significant difference with the ＞50-year old EBV-DLBCL patients (the median OS were 44.2 months and 29.2 months,P =0.587).Conclusions The elderly EBV + DLBCL patients are normally presented with polymorphic and monomorphic patterns.And geographic necrosis are often seen in polymorphic cases.CD30 expression and non-GCB subtypes are high.With the R-CHOP regimen,the OS of the elderly EBV+ DLBCL patients is similar with that of ＞50-year old EBV-DLBCL patients.

摘要： Objective To analyze the clinical characteristics and prognostic factors in patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL),and to improve the diagnosis and treatment of PGI-DLBCL.Methods Retrospective analysis was conducted in 51 cases of PGI-DLBCL between January 2009 and August 2013.The data included clinical manifestations,pathological features,treatment regimens and prognosis.Results 51 patients included 31 males and 20 females,the range of ages was from 16 to 80 years old,median age was 48 years old.The major clinical presentation were abdominal pain,abdominal distension,abdominal mass,nausea and vomiting,abdominal mass.The occurrences in stomach,small intestine,colon,rectum and multiple involvement were 56.86 ％,29.41％,7.84 ％,1.90 ％ and 3.92 ％ respectively.The mass bigger than 10 cm was found in 13 cases (25.49 ％).47.06 ％ (24/51) of the cases belonged to the GCB subtype and 52.94 ％ (27/51) belonged to the non-GCB subtype.There was no significant impact of lymphoma cell origin,disease distribution (stomach or intestinal) and mass on prognosis of lymphoma treatment.The univariate analysis revealed that the patients with Lugano stage Ⅳ,increased level of serum lactate dehydrogenase (LDH),modified-international prognosis index (modified IPI) 3-5 and increased level of CA125 had poor prognosis (all P ＜ 0.05).There was no difference of survival rate between patients treated with rituximab plus chemotherapy and single CHOP like therapy.Surgery plus postoperative chemotherapy significantly improved survival of patients treated with simple chemotherapy (P ＞ 0.05).Conclusion The clinical Lugano stage,IPI score,increased LDH and CA125 are important prognostic factors of PGI-DLBCL.%目的 探讨原发性胃肠道弥漫大B细胞淋巴瘤(PGI-DLBCL)的临床特征及预后.方法 对2009年1月至2013年8月收治的51例PGI-DLBCL患者的临床病理资料、治疗方法和预后进行回顾性分析.结果 51例PGI-DLBCL患者中,男31例,女20例,中位发病年龄48岁(16～80岁),患者临床表现主要为腹痛、腹胀、腹部肿块、恶心、呕吐等;原发于胃29例(56.86％),小肠15例(29.41％),结肠4例(7.84％),直肠1例(1.90％),混合部位2例(3.92％).包块直径≥10 cm患者13例(25.49％).24例(47.06％)肿瘤细胞来源于生发中心(GCB),27例(52.94％)来源于非生发中心(non-GCB).单因素分析显示肿瘤细胞来源、原发部位(胃或肠道)和大包块对患者预后无明显影响;Lugano分期Ⅲ～Ⅳ期、乳酸脱氢酶(LDH)增高、国际预后指数(IPI)评分3～5分和CA125增高组患者的3年生存率低于Lugano分期Ⅰ～ⅡE期、LDH正常、IPI评分0～2分和CA125正常组患者,差异均有统计学意义(均P＜ 0.05).利妥昔单抗联合CHOP样方案化疗组患者同单纯CHOP样方案化疗组患者生存率差异无统计学意义(P＞0.05),手术联合化疗组患者生存率高于单纯化疗组.结论 Lugano分期、IPI评分、LDH增高、CA125增高对于预测PGI-DLBCL患者的生存和指导治疗有重要意义.

摘要： Diffuse large B-cell lymphoma (DLBCL) has a high degree of heterogeneity in clinical manifestations,pathological morphology and genetic features.According to its classification by WHO in 2008 WHO,DLBCL is defined as large B-cell lymphoma with diffuse growth and having nuclei similar with or larger than those of normal macrophages.In recent years,the clinical features,morphology,immunohistochemistry,and even gene expression pattern are integrated for classification of DLBCL.It's a new era to stratify DLBLC by gene expression profile.This article summarized research progress in DLBCL classification based on gene expression profile and immunohistochemistry and its effects on prognosis of DLBCL.%弥漫大B细胞淋巴瘤(DLBCL)在临床表现、病理形态和遗传学特征方面具有高度异质性.从形态学角度,2008年WHO分类将DLBCL定义为弥漫生长的大B细胞淋巴瘤,其细胞核等大或大于正常巨噬细胞核.近几年,研究着重于将临床特征、形态学、免疫组织化学甚至基因表达谱融合到DLBCL的分类中,通过基因表达谱来对DLBCL进行分类.文章从DLBCL基因表达谱分类、免疫组织化学分型及其对预后的作用等方面进行综述.

摘要： 目的 探讨原发睾丸弥漫大B细胞淋巴瘤的临床特点和治疗策略.方法 回顾性分析9例原发睾丸弥漫大B细胞淋巴瘤患者的临床资料.结果 9例原发睾丸弥漫大B细胞淋巴瘤患者,按照Ann Arbor临床分期ⅠE期A6例,ⅢE期A1例,Ⅳ期A1例,Ⅳ期B1例,行睾丸根治切除术后接受了放疗和化疗联合治疗或仅行化疗,初次治疗失败后改用其他挽救性化疗方案并定期随访.本组病例随访1～60个月,一线治疗采用R-CHOP或CHOP方案化疗,初次化疗有效率为88.9％,其中完全缓解率为77.8％,部分缓解率为11.1％,未缓解率为11.1％,中位生存时间为26个月.结论 原发睾丸弥漫大B细胞淋巴瘤术后接受辅助化疗等综合治疗,可以提高无进展生存期及总生存期.

摘要： 目的 探讨1例骨孤立性浆细胞瘤(SPB)进展为多发性骨髓瘤(MM)后发生弥漫大B细胞淋巴瘤(DLBCL)患者的临床特点.方法 分析该患者不同时间的临床特点、病理表现和治疗经过,并复习相关文献.结果 患者SPB确诊后2年内治疗有效,病情稳定;2年后进展为MM;1年后发生DLBCL,对化疗耐药.结论 SPB在治疗过程中部分可转化为MM,但也可发生其他肿瘤.因此,在病变治疗过程中,需要及时进行活组织检查,明确病变的性质及是否发生转化.

摘要： 本发明涉及生物医药技术领域，具体是一种多肽及其在制备预防或治疗活化B细胞型弥漫大B细胞淋巴瘤药物中的应用。本发明的多肽能够特异性抑制活化B细胞型弥漫性大B细胞淋巴瘤细胞增殖，促进活化B细胞型弥漫性大B细胞淋巴瘤细胞死亡，具有在制备防治活化B细胞型弥漫大B细胞淋巴瘤病变过程中良好的应用前景。

摘要： 本文描述了用于分类DLBCL亚型的创新，以及将该分类结果用于诊断、预后以及治疗选择的创新。以此方式，该分类器可有效地分类DLBCL亚型并提供有意义的输出，有利于医疗实践和DLBCL患者。还描述了可用于测量DLBCL标签基因的表达的阵列和试剂盒。

摘要： 本发明涉及生物医药技术领域，具体是一种多肽及其在制备预防或治疗活化B细胞型弥漫大B细胞淋巴瘤药物中的应用。本发明的多肽能够特异性抑制活化B细胞型弥漫性大B细胞淋巴瘤细胞增殖，促进活化B细胞型弥漫性大B细胞淋巴瘤细胞死亡，具有在制备防治活化B细胞型弥漫大B细胞淋巴瘤病变过程中良好的应用前景。

摘要： 本发明公开了一种弥漫性大B细胞淋巴瘤分子分型试剂盒及分型装置，属于癌症诊断和分子生物学领域。本发明的试剂盒和分型装置，通过检测CCL22基因、DOCK10基因、FAM129C基因、FCMR基因、GPR183基因、JADE3基因、MIR155HG基因、MPEG1基因、NLRP7基因、P2RX5基因、TOX2基因、CD83基因、CILP基因、CR2基因、HOPX基因、RGCC基因、STAG3基因、TUBB2A基因、UCHL1基因和VPREB3基因等基因的表达量进行分型，为进一步完善、改进弥漫性大B细胞淋巴瘤分型诊断提供了新的工具，应用前景良好。

摘要： 本发明涉及生物检测领域，具体涉及一种弥漫大B细胞淋巴瘤的分型方法、分型模型，还涉及一种用于对弥漫大B细胞淋巴瘤的靶向测序试剂盒和分型试剂盒。方法包括：获取最低样本量的弥漫大B细胞淋巴瘤样本；检测弥漫大B细胞淋巴瘤样本中18个相关基因的突变信息；将突变信息采用PAM算法聚类，建立分型模型，获得分出包含MCD型、N1型、EZB型、BN2型和Others型的分型模型。通过一致性的比较发现，应用NEJM50基因模型分出的结果和本发明的模型结果高度一致，本发明仅通过检测18个基因的突变信息即可完成分型，且测序成本较低、便于临床推广、降低了检测成本、经济实惠。

摘要： 本发明属于生物技术领域，具体涉及一组用于评估弥漫大B细胞淋巴瘤分子分型的基因群，其试剂盒及分析方法。本发明的用于评估弥漫大B细胞淋巴瘤分子分型的基因群至少由178个基因组成。本发明采用全转录组测序检测基因表达水平并用于分子分型，增加了检测的敏感度，提高了检测能力和效率，同时极大降低了检测成本。经实验验证，本发明试剂盒适用范围广、准确率高，有助于实现个性化用药。

摘要： 本发明公开CD20‑可稳定传代的GCB型人弥漫大B细胞淋巴瘤动物模型，人弥漫大B细胞淋巴瘤CYP6，其保藏编号为：CCTCC NO:C201772，人弥漫大B细胞淋巴瘤细胞系CYP6D，其保藏编号为：CCTCC NO:C201771。本发明提供的动物模型能更真实的反映DLBCL的疾病特征，为进一步研究DLBCL细胞在体内生物学行为及试制新的治疗手段提供了一可靠的途径。同时形成稳定可传代的CD20‑的动物模型和细胞株，更自然的反应了GCB型DLBCL耐药的过程，为此类肿瘤耐药机制的研究提供了良好的模型，为体内和体外实验的开展奠定了良好的基础和条件。

摘要： 本文描述了用于分类DLBCL亚型的创新，以及将该分类结果用于诊断、预后以及治疗选择的创新。以此方式，该分类器可有效地分类DLBCL亚型并提供有意义的输出，有利于医疗实践和DLBCL患者。还描述了可用于测量DLBCL标签基因的表达的阵列和试剂盒。

摘要： 本发明提供一种弥漫性大B细胞型淋巴瘤动物模型的建立方法，包括：(1)接种和(2)鉴定。由本发明的方法获得的模型具有稳定传代型腔强的特点，并保持原代DLBCL的生物学特性，所以比目前广泛应用的其他模型具有更广阔的应用价值。稳定传代后成瘤周期短(约20天)，发病后小鼠生命体征稳定时间长(≥22天),所以无论是在从事发病机制相关还是治疗相关的研究中，均能很大程度上反应病人体内真实的状况，使得研究成果的转化有据可循，并且能够更加快速地将研究的成果向临床转化，对进一步开展有临床应用前景的研究有很大价值。

摘要： 本发明公开一种弥漫性大B细胞淋巴瘤分子病理分型方法，将三种不同波长的量子点标记物作为荧光探针，检测生物样品中CD10、Bcl-6和MUM1蛋白的表达。本发明还公开了用于弥漫性大B细胞淋巴瘤分子病理分型的试剂盒及其应用。本发明弥漫性大B细胞淋巴瘤分子病理分型方法，显著提高了工作效率，且对弥漫性大B细胞淋巴瘤患者采取合理的治疗方案，有利于节省医疗费用。