Combining CAPRA-S With Tumor IDC/C Features Improves the Prognostication of Biochemical Recurrence in Prostate Cancer Patients

Background: Intraductal carcinoma and cribriform (IDC/C) tumor features are well-established prognosticators of biochemical recurrence (BCR), metastasis, and prostate cancer (PCa)-specific mortality. However, approximately 70% of PCa patients undergoing a radical prostatectomy are IDC/C negative, yet up-to 20% of these patients progress and experience BCR. Thus, tumor histopathologic characteristics such as IDC/C alone are limited in their ability to predict disease progression. Conversely, several nomograms such as Cancer of the Prostate Risk Assessment-Surgery (CAPRA-S) have been developed to aid in the prognostication of BCR, but not yet widely applied in clinical settings. Materials and methods: In this study, we assessed the combined prognostic utility of IDC/C, and CAPRA-S for BCR in 3 PCa patient cohorts. Results: CAPRA-S+IDC/C improved the predictive accuracy of BCR in all 3 cohorts (P < .001). Specifically, among IDC/C negative cases, CAPRA-S improved the prognostication of BCR in low-risk (Cohort 1; P < .001, Cohort 2; P < .001, Cohort 3; P = .003), intermediate (Cohort 1; P < .001, Cohort 2; P = .006, Cohort 3; P = .03) and high-risk (Cohort 1-3; P < .001) patients. Conversely, IDC/C improved the prognostication of BCR among CAPRA-S low-risk (Cohorts 1; P < .001 and Cohort 3; P = .003) patients. Conclusion: Our results suggest the investigation of histopathological IDC/C features in CAPRA-S low-risk patients and conversely, nomogram CAPRA-S among IDC/C negative patients improves the identification of patients likely to experience BCR, which would otherwise be missed through current assessment regimens. These patients can be offered more intensive monitoring and adjuvant therapies upfront to circumvent the development of recurrent cancer or overtreatment at the time of surgery.     

STAT3 couples with 14-3-3σ to regulate BCR signaling,B-cell differentiation,and IgE production

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细胞因子在慢性髓系白血病中的研究进展

慢性髓系白血病（chronic myeloid leukemia CML）是一类起源于造血干细胞的恶性克隆性疾病,酪氨酸激酶抑制剂(TKI)对CML慢性期有很好的治疗效果,但治疗过程中会出现耐药、发生急变。CML急变和TKI的耐药是目前影响该病治疗和预后的主要障碍。近年来研究发现细胞因子网络紊乱及其活动与CML是相关的,造血微环境中许多造血和趋化相关的细胞因子在CML中异常表达。细胞因子在CML的进展和耐药中起到重要作用。本文将对细胞因子在CML进展机制中的作用,细胞因子与临床耐药的相关性及当前针对细胞因子的新的治疗方法等方面作一综述。     

中性粒细胞异常增殖相关的BCR/ABL-慢性白血病的临床特征

目的:探讨与中性粒细胞异常增殖相关的BCR/ABL-慢性白血病的临床特征.方法:报告3例不同类型与中性粒细胞异常增殖相关的BCR/ABL-慢性白血病并结合文献进行讨论.结果:3例均为老年男性,表现为以中性粒细胞为主的白细胞异常增多、BCR/ABL融合基因阴性.例1诊断为慢性中性粒细胞白血病(CNL),脾大,外周血以成熟中性粒细胞增高为特征,胞浆内中毒颗粒易见,无明显病态造血,中性粒细胞碱性磷酸酶(NAP)染色强阳性,骨髓粒系增生明显活跃.例2诊断为不典型慢性髓细胞白血病(aCML),血涂片示不成熟粒细胞比例增高伴粒系病态造血,尤其核染色质异常浓聚更为明显,骨髓象表现为髓系增生和病态造血,原始细胞轻度增多.例3诊断为慢性粒单核细胞白血病(CMML),外周血成熟单核细胞数量和比例异常偏高,粒系病态如核分叶过多、环状核和假性Pelger-Huet畸形等易见,骨髓髓系增生明显活跃伴病态造血,无原始细胞增多.结论:中性粒细胞异常增殖相关的BCR/ABL-慢性白血病较为少见,易于误诊,细胞形态学特征是诊断BCR/ABL-慢性白血病的基础.临床表现、多种实验室检查结果尤其是分子生物学等有助于正确诊断这类疾病.     

慢性粒细胞性白血病中SHIP1基因的表达变化及机制探讨

目的观察SHIP1基因在慢性粒细胞性白血病(CML)患者中的表达变化,并通过特异性小干扰RNA(siRNA)封闭K562细胞株BCR-ABL基因的表达,探讨BCR-ABL基因表达对SHIP1基因的影响。方法应用RQ-PCR方法检测CML患者骨髓、正常人外周血白细胞及白血病细胞株K562中SHIP1基因表达的差异。另取K562细胞分为3组:空白对照组(不加任何干扰成分);非特异性siRNA处理组(加非特异性siRNA);特异性siRNA处理组(加入特异性siRNA封闭BCR/ABL融合基因),应用RQ-PCR及Western blot方法分别检测3组中BCR/ABL、SHIP1基因的mRNA及其相应蛋白P210(BCR/ABL编码)、P145(SHIP1基因编码)的表达,并比较各组中表达水平的变化。结果CML患者骨髓白细胞和K562细胞中SHIP1基因的表达明显低于正常人的外周血白细胞。特异性siRNA处理组中BCR-ABL基因mRNA和P210蛋白的表达水平明显下降,SHIP1基因mRNA和P145蛋白表达水平随BCR-ABL表达下降而增加;非特异性siRNA处理组与空白组相比无明显差异。结论CML患者SHIP1基因的表达低于正常人;特异性siRNA能够抑制BCR-ABL基因的表达;BCR-ABL基因能抑制SHIP1基因及其蛋白表达。     

HBV疫苗接种后高、低、无应答个体B细胞特征的研究进展

乙型肝炎病毒(hepatitis B virus,HBV)感染一直以来都是世界范围内严重的公共卫生问题,可导致急、慢性肝脏疾病以及多种并发症。接种HBV疫苗诱导机体B细胞分泌保护性的乙型肝炎病毒表面抗体(hepatitis B surface antibody,HBsAb)是预防HBV感染最重要的措施。研究表明不同个体对HBV疫苗应答的效应不一致,可分为超高/高、正常/中等、低/无应答,对其产生机制的研究可为高滴度HBsAb制备、HBV感染防治等提供参考。本文将对HBV疫苗接种后不同应答效应个体B细胞特征和机制的研究概况与进展进行综述。     

Deletion of WASp and N-WASp in B cells cripples the germinal center response and results in production of IgM autoantibodies

Humoral immunodeficiency caused by mutations in the Wiskott-Aldrich syndrome protein (WASp) is associated with failure to respond to common pathogens and high frequency of autoimmunity. Here we addressed the question how deficiency in WASp and the homologous protein N-WASp skews the immune response towards autoreactivity. Mice devoid of WASp or both WASp and N-WASp in B cells formed germinal center to increased load of apoptotic cells as a source of autoantigens. However, the germinal centers showed abolished polarity and B cells retained longer and proliferated less in the germinal centers. While WASp-deficient mice had high titers of autoreactive IgG, B cells devoid of both WASp and N-WASp produced mainly IgM autoantibodies with broad reactivity to autoantigens. Moreover, B cells lacking both WASp and N-WASp induced somatic hypermutation at reduced frequency. Despite this, IgG1-expressing B cells devoid of WASp and N-WASp acquired a specific high affinity mutation, implying an increased BCR signaling threshold for selection in germinal centers. Our data provides evidence for that N-WASp expression alone drives WASp-deficient B cells towards autoimmunity.