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弥漫性大B细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤的常见类型。该疾病经过正规治疗,部分是可治愈的。患者的预后因具有不同的遗传学表现而对治疗反应各异,表明这是一组异质性肿瘤。国际预后指数(IPI)可用于判断DLBcL患者的预后,但IPI相同者的生存期并不一致,说明IPI亚组中仍存在着异质性。根据已发现的遗传学特异改变以及对蛋白表达水平的检测,可确定多个能够独立于临床指标、判断DLBCL患者预后的分子标记物,是对国际预后指数的丰富和发展。近来,随着DNA微阵列及组织阵列技术的应用,可以更好的理解淋巴瘤生物学表现,并促进了新型诊断方法的进展,有利于改进了现有的预后判断模型。然而,在涉及不同预后指标的重要性及常规应用性等方面,文献资料并不统一。本综述总结了判断DLBCL预后标记物的最新进展,并讨论了目前以标记物评估DLBCL治疗风险、指导治疗的可行性。
Diffuse large B-cell lymphoma (DLBCL) is a common type of non-Hodgkin’s lymphoma. The disease is formally treated and partially curable. The patient’s prognosis varies from treatment to treatment due to different genetic manifestations, indicating that this is a heterogeneous group of tumors. International prognostic index (IPI) can be used to determine the prognosis of patients with DLBcL, but the same IPI survival time is not consistent, indicating that there is still heterogeneity in the subgroup of IPI. Based on the identified genetic changes and detection of protein expression, multiple molecular markers that can be used to determine the prognosis of patients with DLBCL independently of the clinical data can be used to enrich and develop the International Prognostic Index. Recently, with the application of DNA microarray and tissue array technology, it is possible to better understand the biological manifestations of lymphoma and to promote the progress of new diagnostic methods, and to improve the existing prognostic models. However, the literature is not uniform in terms of the importance and routine applicability of different prognostic indicators. This review summarizes recent advances in judging DLBCL prognostic markers and discusses the current feasibility of using markers to assess the risk of DLBCL therapy and to guide therapy.