Molecular diagnosis of Burkitt's lymphoma
Molecular diagnosis of Burkitt's lymphoma
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DOI：
10.1056/nejmoa055759
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发表时间：
2006-06-08
影响因子：
158.5
通讯作者：
Staudt, Louis M.
中科院分区：
文献类型：
--
作者：
Dave, Sandeep S.;Fu, Kai;Staudt, Louis M.
背景：伯基特淋巴瘤和弥漫性大B细胞淋巴瘤的区别是至关重要的，因为这两种类型的淋巴瘤需要不同的治疗方法。我们研究了基因表达谱是否可以可靠地区分伯基特淋巴瘤弥漫性大B细胞lymphoma.Methods：肿瘤活检标本从303例侵袭性淋巴瘤的基因表达进行了分析，并根据形态学，免疫组化，和检测的t（8;14）c-myc translocation.Results：分类的基础上基因表达正确地确定了所有25例经典伯基特淋巴瘤的病理证实。伯基特淋巴瘤与弥漫性大B细胞淋巴瘤的区别在于c-myc靶基因的高水平表达、生殖中心B细胞基因亚群的表达以及主要组织相容性复合体I类基因和核因子κ B靶基因的低水平表达。8例病理诊断为弥漫性大B细胞淋巴瘤的标本具有伯基特淋巴瘤的典型基因表达谱，这表明它们代表了目前方法难以诊断的伯基特淋巴瘤病例。伯基特淋巴瘤的分子诊断的28例患者中，总生存率是上级那些谁接受了强化化疗方案，而不是较低剂量的regiments.Conclusions：基因表达谱是一个准确的，定量的方法区分伯基特淋巴瘤弥漫性大B细胞淋巴瘤。
Background:The distinction between Burkitt's lymphoma and diffuse large-B-cell lymphoma is crucial because these two types of lymphoma require different treatments. We examined whether gene-expression profiling could reliably distinguish Burkitt's lymphoma from diffuse large-B-cell lymphoma.Methods:Tumor-biopsy specimens from 303 patients with aggressive lymphomas were profiled for gene expression and were also classified according to morphology, immunohistochemistry, and detection of the t(8;14) c-myc translocation.Results:A classifier based on gene expression correctly identified all 25 pathologically verified cases of classic Burkitt's lymphoma. Burkitt's lymphoma was readily distinguished from diffuse large-B-cell lymphoma by the high level of expression of c-myc target genes, the expression of a subgroup of germinal-center B-cell genes, and the low level of expression of major-histocompatibility-complex class I genes and nuclear factor-kappa B target genes. Eight specimens with a pathological diagnosis of diffuse large-B-cell lymphoma had the typical gene-expression profile of Burkitt's lymphoma, suggesting they represent cases of Burkitt's lymphoma that are difficult to diagnose by current methods. Among 28 of the patients with a molecular diagnosis of Burkitt's lymphoma, the overall survival was superior among those who had received intensive chemotherapy regimens instead of lower-dose regimens.Conclusions:Gene-expression profiling is an accurate, quantitative method for distinguishing Burkitt's lymphoma from diffuse large-B-cell lymphoma.