The Lymph2Cx assay effectively discriminate ABC type DLBCLs from non-GCB diseases, however, COO alone was not associated with survival outcomes in transplant-eligible patients with high-risk DLBCL. Upfront ASCT may improve survival in high risk ABC patients in PR as well as CR. Digital GEP identified strong correlations between RAB7L1 and S1PR2 expression levels and disease prognosis, although this requires further validation.
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ABSTRACT(IN KOREAN)
활성화 B세포 형태의 광범위 큰 B세포 림프종에서 B세포 수용체 신호전달 억제에 대한 예측 생체지표 연구
<지도교수 김 진 석>
연세대학교 대학원 의학과
이 혜 원
연구 배경: 광범위큰B세포림프종(diffuse large B-cell lymphoma, DLBCL)은 국내 악성림프종 중 가장 흔한 형태이며, 유전자 발현 프로파일링 (gene expression profiling, GEP) 양상에 따라 분자적 세부 아형으로 나뉜다. 이는 세포의 기원 (cell-of-origin, COO)에 기반한 유전자 발현 양상에 따라, 크게 germinal center B cell (GCB) 타입과 activated B-cell (ABC) 타입으로 분류된다. ABC 타입 DBLCL은 특징적인 유전자 발현 과 함께 상대적으로 불량한 예후를 보이는 것으로 알려져 있다. ABC 타입을 구분해내기 위해서 임상 현장에서는 대리 표지자로서 CD10, BCL6, MUM1을 이용한 면역조직화학염색 (immunohistochemistry, IHC)이 널리 사용되고 있으며, 최근에는 보다 정밀하고 활용도가 높은 디지털 GEP가 도입되었다. 본 연구에서는 IHC를 통해 non-GCB로 분류된 고위험군 DLBCL 환자를 대상으로 digital GEP를 수행하여 세포기원의 임상적 중요성을 확인하고자 하였다. 동시에 본 대상군에서 유의한 유전자적 표지자를 탐색해보고자 하였다.
연구 방법: 본 연구에서는 디지털 GEP를 위해 NanoString 및
nCounter 분석법을 활용하였으며, 종양검체는 포르말린 고정
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