弥漫性大B细胞淋巴瘤继发中枢神经系统受累的预测研究现状  

Current research status on prediction of diffuse large B cell lymphoma with secondary central nervous system involvement

作　　者：聂星雨 许芳[2] Nie Xingyu;Xu Fang(Graduate School,Chengdu Medical College,Chengdu 610500,Sichuan Province,China;Department of Hematology,Mianyang Central Hospital,Mianyang 621000,Sichuan Province,China)

机构地区：[1]成都医学院研究生院,成都610500 [2]绵阳市中心医院血液科,绵阳621000

出　　处：《国际输血及血液学杂志》2024年第2期119-124,共6页International Journal of Blood Transfusion and Hematology

基　　金：四川省医学科研课题计划(S22040);绵阳市中心医院2021年度孵化课题(2021FH008)。

摘　　要：弥漫性大B细胞淋巴瘤(DLBCL)是成年人最常见的侵袭性非霍奇金淋巴瘤(NHL)。虽然R-CHOP(利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松)等方案,使DLBCL患者临床结局有所改善,但是仍有约5%DLBCL患者继发中枢神经系统(CNS)受累,并且预后较差。由于对所有DLBCL患者进行CNS受累预防治疗的临床价值不高,因此尽早识别CNS受累高危患者并对其进行预防治疗,是避免DLBCL继发CNS受累的重要措施。目前,CNS-国际预后指数(IPI)模型是DLBCL继发CNS受累患者的常用预测模型,以其为基础构建的CNS-IPI-C模型,虽尚未广泛应用,但对CNS受累高危患者具有较好识别能力。白细胞介素(IL)、CD5、微小RNA(miRNA)、循环肿瘤DNA(ctDNA)等生物标志物,也逐渐在该病中展现较高预测价值。笔者拟就目前临床对DLBCL继发CNS受累的预测模型及潜在生物标志物的最新研究现状进行阐述,旨在为早期精准发现CNS受累高危患者提供依据。Diffuse large B-cell lymphoma(DLBCL)is the most common aggressive non-Hodgkin lymphoma(NHL)in adults.Although the usage of regimens such as R-CHOP(rituximab+cyclophosphamide+doxorubicin+vincristine+prednisone)have led to an improvement in the clinical outcome of patients with DLBCL,there are still approximately 5%of DLBCL patients who have secondary central nervous system(CNS)involvement and poor prognosis.Because the clinical value of prophylaxis for CNS involvement in all DLBCL patients is limited,early identification and prophylaxis of high-risk factors for secondary CNS involvement patients is an important measure to avoid secondary CNS involvement in DLBCL patients.Currently,the CNS-International Prognostic Index(IPI)model is the commonly used prediction models for secondary CNS involvement in DLBCL patients,and CNS-IPI-C model constructed on its basis,although not widely used,has good ability to identify high-risk patients.Biomarkers such as interleukin(IL),CD5,microRNA(miRNA),and circulating tumor DNA(ctDNA)are also gradually demonstrating high predictive value in this disease.The author intends to elaborate on the current research status on predictive models and potential biomarkers for DLBCL with secondary CNS involvement,aiming to provide a basis for early and precise detection of high-risk patients.

关 键 词：淋巴瘤 大B细胞 弥漫性 中枢神经系统肿瘤 预测 白细胞介素类 循环游离DNA 

分 类 号：R733.1[医药卫生—肿瘤]