Аннотация
Лимфома из клеток мантии (МКЛ) — вариант периферической В-клеточной неходжкинской лимфомы, характеризуется конститутивной гиперэкспрессией циклина D1, приводящей к дисрегуляции клеточного цикла и нарушению процессов репарации повреждений в ДНК. Помимо типичной транслокации t(11;14)(q13;q32) и более редких вариантов t(2;11)(p11;q13), t(11;22)(q13;q11) у значительного числа пациентов нередко выявляются вторичные молекулярные и хромосомные аберрации, обусловливающие гетерогенность клинического течения МКЛ. Среди широкого спектра молекулярно-генетических нарушений в последние годы особое внимание уделяется изучению так называемой double-hit МКЛ в подгруппе пациентов с транслокациями, вовлекающими гены CCND1 и MYC. «Double-hit» МКЛ отличается быстрым прогрессированием и генерализацией опухоли ко времени постановки диагноза. Неблагоприятный прогноз и низкие показатели выживаемости у большей части пациентов с МКЛ обусловливают необходимость в максимально быстрой постановке диагноза. Применение морфологических и иммуногистохимических методов исследования наряду с генетическими (стандартным цитогенетическим исследованием и флюоресцентной гибридизацией in situ) способствует улучшению качества диагностики с высокой доказательной базой. Результаты комплексных диагностических исследований создают оптимальные условия в клинике для оценки прогноза и выбора наиболее адекватной тактики лечения.
Библиографические ссылки
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