多发性骨髓瘤克隆异质性与克隆演化研究进展  

Research Progress of Clonal Heterogeneity and Clonal Evolution in Multiple Myeloma

作　　者：崔思远 于丽明 宁微微[3] 王振振 孔凡盛 徐瑞荣 CUI Si-yuan;YU Li-ming;NING Wei-wei;WANG Zhen-zhen;KONG Fan-sheng;XU Rui-rong(Affiliated Hospital of Shandong University of Traditional Chinese Medicine,The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Ji＇nan 250014,China;Hospital of JIER Machinary-toal Group,Ji＇nan 250000,China;Ji＇nan Hospital,Ji＇nan 250000,China)

机构地区：[1]山东中医药大学附属医院、山东中医药大学第一临床医学院,山东济南250014 [2]济南二机床集团有限公司职工医院,山东济南250000 [3]济南医院,山东济南250000

出　　处：《肿瘤学杂志》2018年第10期941-947,共7页Journal of Chinese Oncology

基　　金：山东省医药卫生科技发展计划项目(2013WS0249)

摘　　要：克隆异质性与克隆演化是近几十年来肿瘤领域的新的重要理论之一,该理论的提出得益于新技术手段的临床应用,如比较基因组杂交技术、全基因组外显子测序技术、表观遗传学测序技术等。克隆异质性与克隆演化为理解肿瘤难治耐药的机制提供了新的视角。20余年前,克隆异质性与克隆演化的概念在多发性骨髓瘤（MM）中被首次确认。多发性骨髓瘤作为一种不可治愈性的浆细胞肿瘤,普遍存在＂癌前病变＂-意义未明的单克隆免疫球蛋白血症（MGUS）,克隆异质性与克隆演化在MGUS发展为MM的过程中扮演着重要角色。全文从动物模型、深度测序技术应用、临床随访、疾病的发生发展、细胞遗传学、骨髓微环境及临床应用等方面对MM克隆异质性及克隆演化做一综述。Clonal heterogeneity and clonal evolution have emerged as critical concepts in the field of oncology over the past four decades,largely thanks to the implementation of novel technologies such as comparative genomic hybridization,whole genome/exome sequencing and epigenetic analysis. Clonal heterogeneity and clonal evolution provide us with a new perspective to understand the mechanism of refractory nature and drug resistance of tumors. More than 20 years ago,the concept of clonal evolution and clonal heterogeneity was confirmed for the first time in multiple myeloma（MM）. MM is a kind of incurable plasma cell malignancy,derived from the universally existing precancerous lesion-monoclonal gammopathy of undetermined significance（MGUS）.Cloning heterogeneity and evolution plays a very important role in the process of MGUS developing to MM. This article reviews the heterogeneity and clonal evolution of multiple myeloma,from the aspects of animal models,deep sequencing technique,clinical follow-up,occurrence and development of diseases,cytogenetics,bone marrow microenvironment and clinical application.

关 键 词：多发性骨髓瘤 克隆演化 克隆异质性 

分 类 号：R733.3[医药卫生—肿瘤]