弥漫大B细胞淋巴瘤MYD88、A20基因突变的表达及临床意义

目的 分析弥漫大B细胞淋巴瘤（DLBCL）MYD88、A20基因突变的表达及临床意义。方法 收集2015年1月至2022年1月徐州市中心医院收治的DLBCL患者213例,治疗前应用二代测序技术检测患者MYD88、A20基因突变情况,治疗后3个月患者采用PET-CT进行疗效评估,统计不同临床特征、不同治疗效果患者MYD88、A20基因突变的情况。结果 213例患者中MYD88基因突变35.21%,其中72.00%突变点位为L265P;A20基因突变22.54%,均为3号外显子的错义突变。MYD88、A20基因双突变者5.63%。MYD88基因突变者Ki-67高表达、Bcl-2阳性、c-MYC/Bcl-2阳性、疾病类型为ABC-DLBCL型占比明显高于MYD88基因未突变者,差异有统计学意义（P<0.05）。A20基因突变者疾病类型为ABC-DLBCL型、PgP阳性中占比高于A20基因未突变者,差异有统计学意义（P<0.05）。MYD88/A20基因双突变者疾病类型为ABC-DLBCL者高于MYD88/A20基因均未突变者,差异有统计学意义（P<0.05）。治疗有效组17...     

抗人CD20单克隆抗体治疗B细胞淋巴瘤研究进展

近年来,对B细胞淋巴瘤的抗原靶向性治疗已取得了巨大进展。出现了一种新的非常有发展前景的治疗方法。即以B细胞分化抗原CD20为靶抗原的单克隆抗体（McAb)疗法。CD20是非糖基化的跨膜磷酸蛋白,分子质量为35kD。表达在大多数成熟B细胞表达,分化为浆细胞后,CD20表达消失。CD20可能参与B细胞成熟与分化的调节,作为钙离子通道发挥某些生物学作用。更为重要的是,95%以上的B细胞淋巴瘤表达CD20,且无显内化及脱落,这些特点使其成为单克隆抗体疗法的理想靶抗原,临床试验结果表明,抗CD20单克隆抗体既可单独应用,亦可作为放射性同位素或细胞毒制剂的载体,其疗效显,且使用安全,副反应小,许多研究报道已阐明了抗CD20单克隆抗体治疗B细胞淋巴瘤的几种可能的效应机制。目前,人们正致力于探索一些新的治疗策略以期提高这种疗法的特异性,减少其非特异性的毒副作用。     

类似人弥漫型大B细胞淋巴瘤小鼠模型的免疫学特征

本研究建立类似人弥漫型大B细胞淋巴瘤的BALB／c小鼠模型并探索其免疫学特征。将鼠源性B淋巴瘤细胞株（A20细胞）接种于同源BALB／c小鼠以建立B细胞淋巴瘤鼠模型。实验分为3组：成瘤小鼠组,未成瘤小鼠组和正常小鼠组（对照组）。用流式细胞术检测肿瘤细胞CD抗原表达及成瘤小鼠、未成瘤小鼠和对照正常小鼠的外周血和脾脏的T／B淋巴细胞亚群比例。结果表明：在成功构建病理学形态类似人弥漫大B细胞淋巴瘤的BALB／c鼠模型肿瘤组织中,检测到CD3、CD4、CD8、CD19、CD30阳性细胞的比例分别为（49．27±23．75）％,（6．07±3．65）％,（51．2±23．1）％,（67．06±16．39）％,（37．93±17．03）％,与接种前A20细胞相比,其CD3和CD8阳性细胞比例显著升高,CD19阳性表达比例显著下降（P〈0．05）。成瘤小鼠外周血淋巴细胞亚群阳性表达比例较正常小鼠有显著差异,其CD3和CD4阳性细胞比例显著降低（P〈0．05）。未成瘤小鼠脾脏淋巴细胞亚群的阳性表达比例与正常小鼠相比,CD3、CD4、CD8阳性细胞比例降低,而CD19阳性细胞比例升高（P〈0．05）。结论：本研究为在有免疫功能的小鼠体内进行B细胞淋巴瘤相关研究提供了免疫相关实验依据。     

抗CD20单克隆抗体美罗华治疗B细胞淋巴瘤的研究进展

美罗华（Rituximab）是一种抗CD20嵌合型单克隆抗体。它可特异性地与B淋巴细胞表面CD20抗原结合，通过多种机制清除体内的B淋巴细胞。临床资料显示，美罗华治疗B细胞非霍奇金淋巴瘤有效率高，毒副反应小，病人耐受良好，是一种有前途的抗肿瘤新药。     

美罗华治疗B细胞淋巴瘤的护理

目的总结使用美罗华治疗B细胞淋巴瘤的护理要点.方法护理了13例使用美罗华治疗的患者,观察其治疗的效果及副作用,并提出相应的护理措施.结果应用美罗华治疗后有61.5%出现发热、46.2%患者出现寒战、46.2%有血压变化等.结论临床使用美罗华时应重视用药前患者心理护理、掌握给药方法,用药过程严密观察和监测患者生命体征的变化,及时发现不良反应,及时处理.     

EB病毒阳性非特指弥漫大B细胞淋巴瘤研究进展

造血淋巴组织肿瘤(WHO 2016年修订版)将"EB病毒阳性弥漫大B细胞淋巴瘤,非特指"定义为独立病变实体。是一种与EB病毒慢性感染相关的侵袭性B细胞淋巴瘤,具有独特的形态学和生物学行为、治疗反应差、尚无标准治疗方案。本文就其流行病学、发病机制、临床表现、组织病理学特征、免疫表型、分子特征、诊断与鉴别诊断、预后及潜在的治疗措施等方面进行综述。     

B细胞淋巴瘤病理学类型及其遗传学特征

世界卫生组织（WHO）2001年以全书《肿瘤的WHO分类：造血系统肿瘤和淋巴组织肿瘤病理学与遗传学》的形式公布了造血系统肿瘤和淋巴组织肿瘤分类，被称为WHO造血系统肿瘤和淋巴组织肿瘤新分类。新分类将淋巴组织肿瘤分为B细胞肿瘤、细胞和NK细胞肿瘤及霍奇金淋巴瘤3大类。在各肿瘤分类中增加了肿瘤遗传学的内容，成为新分类一个突出的亮点。为了加深临床病理医师对肿瘤遗传学在淋巴瘤诊断、鉴别诊断和预后判断中的作用的认识，本文就B细胞淋巴瘤病理学类型及其遗传学特征进行介绍。     

边缘区B细胞淋巴瘤

边缘区B细胞淋巴瘤（MmpnalZ0neKcelllylnphoma－AffeCL）一又是80年代开始先后分别报告的粘膜组织相关淋巴组织淋巴瘤（。。latedl｝rnphoidtissuel｝mph。NIAL17LA）、单核样B细胞淋巴瘤（menocytoidKcelllymphoma，MBCL）以及脾边缘区细胞淋巴瘤卜pfenicmarginalzonecelll｝mpboma，SMCL）的总称。后来观察研究表明这三种淋巴瘤虽然发生的器官不同，其生物学习性、细胞发生、组织学改变等有共同之处：（）三者共同发生于淋巴滤泡边缘区细胞；（2）瘤细胞由单核样B细胞、裂核样及浆细胞分化细胞组成；门）均为B细胞表型；（4）…     

Myc可控表达的B细胞淋巴瘤小鼠模型的建立

目的建立Myc可控表达的B细胞淋巴瘤小鼠模型。方法将p53敲除小鼠的骨髓细胞与编码Myc雌激素受体融合蛋白(MycER)病毒包装的细胞混合后注入小鼠皮下。腹腔注射他莫昔芬(TAM),1次/d。结果正常对照组小鼠未出现肿瘤;模型组小鼠持续注射TAM后,肿瘤迅速生长。停止注射TAM后,肿瘤大小迅速减小。3周后,肿瘤恢复生长,但速度较慢;此时若注射TAM,肿瘤生长异常加速。结论本研究通过TAM实现对Myc"失活"及"激活"两种状态的调控,成功建立Myc可控表达的B细胞淋巴瘤小鼠模型。     

小B细胞淋巴瘤研究进展

自2017版WHO造血和淋巴组织分类更新以来,随着分子生物学相关新技术的发展和应用,有关淋巴瘤的研究又有许多新进展,尤其是分子生物学方面.本文对小B细胞淋巴瘤的主要变化及近几年的新进展进行介绍.     

Human B lymphoma cell line producing B cell growth factor.

Namalva, a human B cell lymphoma line, produced a factor with a molecular weight of approximately 60,000 which enhanced the proliferation of normal activated human B lymphocytes. The factor also enhanced the proliferation of certain B cell lines. It can be distinguished physiologically and biochemically from other lymphokines known to enhance B cell proliferation, namely, interleukin (IL) 1, IL 2, and interferon. The production of B cell growth factor by B cell tumor lines may contribute to their ability to grow autonomously and may reflect an important component of the neoplastic potential of the cell. B cell growth factor produced by tumors may also affect normal cells in vivo.     

A cloned human T cell line cytotoxic for autologous and allogeneic B lymphoma cells

A human cytotoxic T cell clone (MWS-14) with auto-tumor reactivity was established in serum-free medium in a mixed tumor cell culture by repetitive stimulation with fresh autologous lymphoma cells. This clone and its subclones are of the T3+ T4+ T8- phenotype. They were strongly cytotoxic for the autologous lymphoma cells, whereas autologous PHA blasts were not killed. Analysis of the specificity of MWS-14, MWS-14-30, and MWS-14-34 indicated that these CTL clones were cytotoxic for 7/7 allogeneic lymphoma cells, whereas only 3/23 of normal and non-lymphoma cells were lysed. Blocking studies with monoclonal antibodies directed at MHC class I and class II antigens showed that this preferential, anti-lymphoma reactivity was not directed at HLA determinants. The anti-lymphoma activity is not due to an aspecific susceptibility of the lymphoma cells to lysis. In contrast to CTL clones specific for HLA antigens present on the lymphoma cells, T3 and T4 were not involved in the cytotoxic reaction of MWS-14 against the autologous lymphoma cells. The reactivity of this clone could be blocked by a monoclonal antibody directed at leukocyte function-associated antigen. It can be concluded from these results that these T4+ CTL clones recognize a determinant, which is preferentially expressed on autologous and allogeneic lymphoma cells.     

20例乳腺弥漫大B 细胞淋巴瘤超声误诊分析

摘 要 目的 探讨乳腺弥漫大B细胞淋巴瘤（DLBCL）的超声误诊原因。方法 　回顾性分析20例经病理确诊的乳腺DLBCL患者的临床及超声影像学检查资料,分析超声误诊原因。结果 　20 例患者根据常规超声图像有无边界分为肿块型12例和弥漫型8例。9例行应变弹性成像检查,弹性评分2分5例,3分4例;1例行超声造影和SWE检查,超声造影呈不均匀高增强,SWE呈Ⅰ型。超声诊断BI-RADS 4类19例,其中4A类4例、4B类8例及4C类7例;BI-RADS 3类1例。常规超声结合弹性成像、超声造影正确诊断为乳腺淋巴瘤者5例,误诊15例,包括误诊为乳腺癌10例,炎症病变4例,错构瘤1例。结论 DLBCL常规超声检查极易误诊,充分认识其常规超声表现并联合超声造影及弹性成像技术可提高其诊断准确率。     

Alternative V kappa gene rearrangements in a murine B cell lymphoma. An explantation for idiotypic heterogeneity

Idiotype variants of 38C13, a murine B cell lymphoma, have been isolated by immunoselection with antiidiotype mAbs. The V region genes for the kappa light chains and mu heavy chains expressed by these tumor cells were sequenced and compared. There was no evidence for V region somatic point mutation in this tumor. However, while the heavy chain genes were all identical, the light chain genes were all different. The light chain genes of each variant were derived from the V kappa-Ox1 gene family and joined to J kappa 4, whereas the light chain gene of the parental tumor was derived from the V kappa 9 family and joined to J kappa 2. Two of the variants used the identical V kappa gene but differed by the inclusion of a variable number of additional nucleotides in the V/J joint. Thus, the idiotypic heterogeneity of this B cell lymphoma arises as a consequence of alternative light chain rearrangements rather than point mutation. This process repetitively uses members of the same V kappa gene family. Two of the variants use the identical V kappa and J kappa gene segments but differ by the presence of extra nucleotides at the V kappa/J kappa joint.     

A human lymphoma cell line with multiple immunoglobulin rearrangements.

The development of a cell culture system efficient in the establishment of lymphoma cell lines has made it possible to dissect basic biological and molecular aspects of lymphoma cells. We have established a lymphoma cell line from a patient with B cell lymphoma. The cell line has a complex karyotype with translocations involving bands 8q24, 14q32, and 18q21. Molecular analysis revealed that the Myc gene was rearranged; we were unable to demonstrate rearrangement of the Bcl-2 gene. Evaluation of the structure of the heavy chain Ig genes revealed that the cell line carried the same rearrangements as the cells from which the cell line was derived. The pattern of rearrangement, however, was unusual in that there were at least four rearranged bands when DNA cut with HindIII was probed with a fragment of the heavy chain joining region. To further characterize the cell line, subclones were derived. Individual subclones had the same pattern of rearrangement as the parent cell line. The results of these studies provide evidence that multiple rearranged Ig genes may be present in a single clone of cells.     

弥漫性大B细胞淋巴瘤的临床病理研究进展

弥漫性大B细胞淋N（diffuselargeBcelllymphoma,DLBCL）是最常见的淋巴造血系统肿瘤。由于DLBCL表现出明显的异质性,所以对于它确切的分子机制还不是十分清楚。本文将对DLBCL的临床病理特点进行综述。     

An Epstein-Barr virus-negative B lymphoma cell line (THP-2) from a Burkitt's lymphoma of a Japanese patient

An Epstein-Barr virus-negative lymphoma cell line, THP-2, was established from a Burkitt's lymphoma taken from a Japanese patient. THP-2 cells grew in single cell suspension with a doubling time of 24 hr; the cells carried surface-bound mu-lambda immunoglobulins and formed rosettes with IgG antibody-coated ox erythrocytes. THP-2 cells expressed B1, common acute lymphoblastic leukemia (ALL) (J5) and Ia-like antigens of their surface as defined by monoclonal antibodies. Epstein-Barr virus-associated nuclear antigen (EBNA) was not detected. The cell line THP-2 has been maintained for over 5 years. Among the markers examined, only common ALL antigen has been present on the cell surface of THP-2 for these 5 years.