| 贺思捷,贺建霞.原发性中枢神经系统淋巴瘤预后相关分子标志物的研究进展[J].安徽医药,2026,30(10):1931-1937. |
| 原发性中枢神经系统淋巴瘤预后相关分子标志物的研究进展 |
| Advances in prognostic molecular markers of primary central nervous system lymphoma |
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| DOI：10.3969/j.issn.1009-6469.2026.10.005 |
| 中文关键词: 原发性中枢神经系统淋巴瘤 淋巴瘤，大 B细胞，弥漫性 白细胞介素 -10 程序性死亡受体配体 1/2 甲氨蝶呤 预后 综述 |
| 英文关键词: Primary central nervous system lymphoma Lymphoma, large B-cell, diffuse Interleukin-10 Programmed death-ligand 1/2 Methotrexate Prognosis Review |
| 基金项目:山西省自然科学基金项目( 201901D111435) |
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| 中文摘要: |
| 原发性中枢神经系统淋巴瘤( primary central nervous system lymphoma，PCNSL)是脑肿瘤的罕见类型之一，其特征为高度异质性和侵袭性，病理类型通常为弥漫大 B细胞淋巴瘤( diffuse large B-cell lymphoma，DLBCL)。 PCNSL的预后评估体系通常采用国际结外淋巴瘤研究组( International Extranodal Lymphoma Study Group，IELSG)及纪念斯隆 -凯特琳癌症中心( Memorial Sloan-Kettering Cancer Center，MSKCC)所建议的标准评分体系。由于靶向治疗及造血干细胞移植的应用， PCNSL病人的生存率得到改善，使得现有模型预后价值的评估精准性面临挑战。近年来，随着分子生物学研究进展，发现 PCNSL相关基因突变如 MYD88，CD79B，PIM1及 PCNSL相关蛋白标志物如白细胞介素 -10，程序性死亡受体配体 1和 2，RNA相关标志物与多种肿瘤信号通路有关，并且对疾病的预后具有预测价值。一项研究中，接受以甲氨蝶呤为基础，免疫功能正常的化疗病人中 61.0%(25/41)存在 MYD88突变，且年龄 >65岁比其他年龄病人更常见［ 76%(19/25)比 56%(9/16)］，且预示着较差的生存。该研究检索 2006—2024年 PubMed、中国知网、万方数据库收录的 PCNSL相关中英文文献，对 PCNSL中预后相关分子标志物的最新研究进行论述，旨在提高 PCNSL病人预后评估准确性，为进一步建立新的预后模型提供新的研究基础。 |
| 英文摘要: |
| Primary central nervous system lymphoma (PCNSL) is a rare subtype of brain tumors characterized by substantial hetero-geneity and invasiveness, with diffuse large B-cell lymphoma (DLBCL) being its predominant pathological subtype. Prognostic stratifi-cation systems for PCNSL mainly adopt the scoring criteria proposed by the International Extranodal Lymphoma Study Group(IELSG) and the Memorial Sloan-Kettering Cancer Center (MSKCC). The clinical application of targeted therapy and hematopoieticstem cell transplantation has improved the survival outcomes of patients with PCNSL, yet compromised the predictive accuracy of ex-isting prognostic models. In recent years, advances in molecular biological research have identified PCNSL-associated gene mutations (including MYD88, CD79B and PIM1), as well as protein biomarkers such as interleukin-10, programmed death ligand 1 and 2,alongside RNA biomarkers. These molecules participate in multiple oncogenic signaling pathways and possess prognostic predictivepotency for the disease. One relevant study reported that MYD88 mutations were detected in 61.0% (25/41) of immunocompetent pa-tients receiving methotrexate-based chemotherapy. Such mutations were more prevalent in patients older than 65 years [76% (19/25)]compared with younger patients [56% (9/16)], and correlated with inferior survival. This review retrieves Chinese and English litera-ture regarding PCNSL indexed in PubMed, China National Knowledge Infrastructure (CNKI) and Wanfang Database from 2006 to2024. It elaborates on the latest research progress of prognosis-related molecular biomarkers in PCNSL, with the intention of elevat-ing the precision of prognostic evaluation for PCNSL patients and furnishing evidence for the construction of novel prognostic modelsin future investigations. |
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