A mechanistic classification of clinical phenotypes in neuroblastoma.

A mechanistic classification of clinical phenotypes in neuroblastoma.
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DOI:
10.1126/science.aat6768
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发表时间:
2018-12-07
期刊:
Science (New York, N.Y.)
影响因子:
--
通讯作者:
Fischer M
Fischer M
中科院分区:
其他
文献类型:
--
作者:
Ackermann S;Cartolano M;Hero B;Welte A;Kahlert Y;Roderwieser A;Bartenhagen C;Walter E;Gecht J;Kerschke L;Volland R;Menon R;Heuckmann JM;Gartlgruber M;Hartlieb S;Henrich KO;Okonechnikov K;Altmüller J;Nürnberg P;Lefever S;de Wilde B;Sand F;Ikram F;Rosswog C;Fischer J;Theissen J;Hertwig F;Singhi AD;Simon T;Vogel W;Perner S;Krug B;Schmidt M;Rahmann S;Achter V;Lang U;Vokuhl C;Ortmann M;Büttner R;Eggert A;Speleman F;O'Sullivan RJ;Thomas RK;Berthold F;Vandesompele J;Schramm A;Westermann F;Schulte JH;Peifer M;Fischer M

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神经母细胞瘤是一种小儿交感神经系统肿瘤。其临床过程从肿瘤自发消退到致命进展。为了研究不同肿瘤亚型的分子特征,我们对 416 个治疗前的神经母细胞瘤进行了基因组测序,并评估了其中 208 个肿瘤的端粒维持机制。我们发现,肿瘤缺乏端粒维持机制的患者预后良好,而肿瘤具有端粒维持机制的患者预后则要差得多。对于肿瘤具有端粒维持机制并结合 RAS 和/或 p53 通路突变的神经母细胞瘤患者,其生存率最低。在端粒维持阴性肿瘤患者中,无论是否存在这些突变,肿瘤都会自发消退。根据这些数据,我们提出了神经母细胞瘤的机制分类,可能有利于患者的临床管理。
Neuroblastoma is a pediatric tumor of the sympathetic nervous system. Its clinical course ranges from spontaneous tumor regression to fatal progression. To investigate the molecular features of the divergent tumor subtypes, we performed genome sequencing on 416 pretreatment neuroblastomas and assessed telomere maintenance mechanisms in 208 of these tumors. We found that patients whose tumors lacked telomere maintenance mechanisms had an excellent prognosis, whereas the prognosis of patients whose tumors harbored telomere maintenance mechanisms was substantially worse. Survival rates were lowest for neuroblastoma patients whose tumors harbored telomere maintenance mechanisms in combination with RAS and/or p53 pathway mutations. Spontaneous tumor regression occurred both in the presence and absence of these mutations in patients with telomere maintenance-negative tumors. On the basis of these data, we propose a mechanistic classification of neuroblastoma that may benefit the clinical management of patients.
复发的神经母细胞瘤显示出频繁的RAS-MAPK途径突变。
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