将MYC/BCL2双表达添加到NCCN-IPI可能无法将预后值提高到可接受的水平
Naree Warnnissorn1, Nonglak Kanitsap2, Pimjai Niparuck3
1Department of Pathology, Faculty of Medicine, Thammasat University, Pathumthani, Thailand. nareeaw@tu.ac.th.
Blood research
|March 15, 2024
概括
在扩散性大B细胞淋巴瘤 (DLBCL) 中MYC/BCL2双表达 (DE) 并没有显著改善国家综合癌症网络内部预后指数 (NCCN-IPI) 预测疾病进展. 需要进一步的研究来证实其临床效用.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子病理学分子病理学
背景情况:
- MYC/BCL2双表达 (DE) 与R-CHOP化疗治疗的扩散性大B细胞淋巴瘤 (DLBCL) 患者的治疗结果较差有关.
- 国家综合癌症网络内部预后指数 (NCCN-IPI) 是评估DLBCL预后的标准工具.
研究的目的:
- 评估是否将MYC/BCL2双表达 (DE) 纳入NCCN-IPI可以提高接受R-CHOP的DLBCL患者的预后预测.
- 评估DE的临床实用性,作为DLBCL中现有的预后模型的补充.
主要方法:
- 对111名新诊断的DLBCL患者的回顾性分析,这些患者接受了R-CHOP治疗.
- 根据MYC≥40%和BCL2≥50%的表达,对DE进行分类.
- 使用考克斯模型和哈雷尔对无进展生存期 (PFS) 的一致性指数 (c-index) 评估的预后预测.
主要成果:
- 在39%的患者中,MYC/BCL2双表达 (DE) 存在.
- 将DE添加到NCCN-IPI中,导致c指数从0.63增加到0.66.
- 对DE的调整后危险比率在统计上没有显著性 (P=0.117).
结论:
- 将MYC/BCL2双表达 (DE) 添加到NCCN-IPI中并没有显著改善该队列中DLBCL的预后准确性.
- 建议在更大,多样化的队列中进一步验证,以确认DE在DLBCL预后中的临床实用性,特别是在资源有限的环境中.
相关概念视频
Abnormal Proliferation
4.5K
Under normal conditions, most adult cells remain in a non-proliferative state unless stimulated by internal or external factors to replace lost cells. Abnormal cell proliferation is a condition in which the cell's growth exceeds and is uncoordinated with normal cells. In such situations, cell division persists in the same excessive manner even after cessation of the stimuli, leading to persistent tumors. The tumor arises from the damaged cells that replicate to pass the damage to the...
4.5K
Induced Pluripotent Stem Cells
4.1K
Stem cells are undifferentiated cells that divide and produce different cell types. Ordinarily, cells that have differentiated into a specific cell type are terminally differentiated; however, scientists have found a way to reprogram these mature cells so that they dedifferentiate and return to an unspecialized, proliferative state. These cells are pluripotent like embryonic stem cells—able to produce all cell types—and are called induced pluripotent stem cells (iPSCs).
Somatic...
Somatic...
4.1K
Combination Therapies and Personalized Medicine
4.9K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.9K
The Intrinsic Apoptotic Pathway
6.5K
Internal cellular stress, such as cellular injury or hypoxia, triggers intrinsic apoptosis. The B-cell lymphoma 2 (Bcl-2) family of proteins are the primary regulators of the intrinsic apoptotic pathway. For example, during DNA damage, checkpoint proteins, such as Ataxia Telangiectasia Mutated (ATM protein) and Checkpoints Factor-2 (Chk2) proteins, are activated. These proteins phosphorylate p53 which further activates pro-apoptotic proteins, such as Bax, Bak, PUMA, and Noxa, and inhibits...
6.5K
The Retinoblastoma Gene
4.1K
Tumor suppressor genes are normal genes that can slow down cell division, repair DNA mistakes, or program the cells for apoptosis in case of irreparable damage. Hence, they play an essential role in preventing the proliferation of damaged cells.
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
4.1K


