循环肿瘤DNA临床应用于原发纵隔大B细胞淋巴瘤的疗效评估与复发监测  

Clinical Applications of Circulating Tumor DNA in Response Evaluation and Relapse Monitoring of Primary Mediastinal Large B-Cell Lymphoma

作　　者：潘璐 江新苗 腾燕 王宁 黄玲[2] 郭汉国[2] 刘思初 魏小娟 陈菲莉 梁湛丽[2] 李文瑜 PAN Lu;JIANG Xin-Miao;TENG Yan;WANG Ning;HUANG Ling;GUO Han-Guo;LIU Si-Chu;WEI Xiao-Juan;CHEN Fei-Li;LIANG Zhan-Li;LI Wen-Yu(School of Medicine of South China University of Technology,Guangzhou 510006,Guangdong Province,China;Department of Lymphoma,Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,Guangdong Province,China)

机构地区：[1]华南理工大学医学院,广东广州510006 [2]南方医科大学附属广东省人民医院(广东省医学科学院)淋巴瘤科,广东广州510080

出　　处：《中国实验血液学杂志》2025年第2期407-415,共9页Journal of Experimental Hematology

摘　　要：目的:探讨ctDNA在原发纵隔大B细胞淋巴瘤(PMBCL)疗效评估和复发监测中的临床应用价值。方法:回顾性分析本院2010年1月至2020年4月收治的38例PMBCL患者的临床特征、临床疗效及生存状况。ctDNA监测采用靶向二代测序进行。结果:38例患者中,26例为女性,Ann Arbor分期早期(I-II)32例;5年OS率和PFS率分别为74.7%和61.7%;男性、高aaIPI评分的患者预后较差。23例患者基线二代测序结果显示,STAT6(65.2%)、SOCS1(56.5%)、TNFAIP3(56.5%)是最常见的突变基因。SD/PD患者表现出cell cycle、FoxO和TNF信号通路富集。29例患者进行了EOT PET/CT检查,其中16例进行了ctDNA监测,结果12例阴性;6例EOT PET/CT阳性(Deauville 4)患者中有4例进行了ctDNA监测,结果3例阴性,后续未进行任何抗肿瘤治疗,目前仍处于持续缓解状态。结论:ctDNA或可结合PET/CT评估疗效,监测复发,指导PMBCL的治疗。Objective:To explore the clinical significance of circulating tumor DNA(ctDNA)in response evaluation and relapse monitoring for patients with primary mediastinal large B-cell lymphoma(PMBCL).Methods:The clinical characteristics,efficacy and survival of 38 PMBCL patients in our hospital from January 2010 to April 2020 were retrospectively analyzed.The ctDNA monitoring was conducted by targeted next-generation sequencing(NGS).Results:Among the 38 patients,26 cases were female,and 32 cases were diagnosed with Ann Arbor stage I-II.The 5-year overall survival(OS)rate and progression-free survival(PFS)rate were 74.7%and 61.7%,respectively.Males and those with high aaIPI scores(3 points)had a relatively poor prognosis.The NGS results of 23 patients showed that STAT6(65.2%),SOCS1(56.5%),and TNFAIP3(56.5%)were the most common mutated genes.Patients with stable disease(SD)/progressive disease(PD)exhibited enrichment in cell cycle,FoxO,and TNF signaling pathways.A total of 29 patients underwent end-of-treatment PET/CT(EOT PET/CT),and 16 of them received ctDNA monitoring with 12 negative.Among 6 patients with EOT PET/CT positive(Deauville 4),4 underwent ctDNA monitoring,and 3 of them were negative,being still in continuous remission without any subsequent anti-tumor therapy.Conclusion:CtDNA may be combined with PET/CT to assess efficacy,monitor relapse,and guide treatment of PMBCL.

关 键 词：原发纵隔大B细胞淋巴瘤 循环肿瘤DNA PET/CT 疗效评估 复发监测 

分 类 号：R734.5[医药卫生—肿瘤]