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標題: 犬淋巴瘤病患預後分析及以聚合酶鏈鎖反應與免疫組織化學染色方法鑑定腫瘤細胞來源及表現型
Prognostic variables, and clonality and pheno-typing by polymerase chain reaction and immu-nohistochemical methods in canine lymphomas
作者: 楊伊平
Yang, Yi-Ping
關鍵字: Dog;犬;Gene rearrangement;Immunophenotype;Lymphoma;Prognostic factors;基因重組;免疫性狀;淋巴瘤;預後因子
出版社: 獸醫學系暨研究所
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淋巴瘤為犬隻最常見的血液來源惡性腫瘤,其中免疫性狀為近年來廣為研究的預後因子之一,以聚合酶鍊鎖反應偵側抗原受體重組方法擴展對於犬淋巴瘤的診斷與腫瘤細胞來源鑑定。本實驗之研究目的為(一)探討影響接受不同化學治療犬隻的預後變因與(二)比較以免疫組織化學染色及聚合酶鍊鎖反應方法作為判定腫瘤細胞來源的敏感性。研究對象包含80個多中心型及10個皮膚原發型之淋巴瘤病犬。結果顯示在犬多中心型淋巴瘤治療上,以單一doxorubicin藥物及多種藥物合併治療之病犬,於無疾病進展時間及存活時間並無明顯差異,然而以單一doxorubicin治療的犬隻有較高的腫瘤完全反應率;免疫性狀為B細胞的病犬達到腫瘤完全反應的可能性為具T細胞性狀犬隻的九倍(P = 0.089)。臨床亞期、化療前P-glycoprotein表現量及腫瘤對化療的反應顯著影響病犬存活時間。於66個淋巴瘤病例以免疫組織化學染色及聚合酶鍊鎖反應鑑定腫瘤細胞來源分析中,多中心型淋巴瘤包含78.6% (44/56) B細胞、12.5% (7/56) T細胞及8.9% (5/56)細胞來源無法確定的淋巴瘤病例,所有(10個)皮膚型淋巴瘤病例皆具T細胞性狀;雙重表現型及基因型分別在兩個多中心型淋巴瘤病例發現。整體而言,在所有淋巴腫瘤細胞來源分析結果中,免疫組織化學染色較聚合酶鍊鎖反應有較高的敏感性(分別為93.4%及87.0%)。

Lymphoma is the most common hematopoietic malignancy in dogs, and immu-nophenotype is one of the most important prognostic factors studied in the past decade. Polymerase chain reaction (PCR) for antigen receptor rearrangement (PARR) has ex-panded the diagnosis and clonality assay in canine lymphomas. The aim of this study was to define the prognostic variables among dogs that received different chemothera-peutic protocols, and to compare the sensitivity of immunohistochemical (IHC) staining with PCR assay in the determination of tumor lineage. Eighty multicentric and 10 primary cutaneous lymphomas were included. A single-agent doxorubicin protocol presented with a similar efficacy regarding the progression-free and survival times, whereas a significantly higher complete response (CR) rate, with the combination pro-tocol in dogs with multicentric lymphoma. Dogs with B-cell phenotype were 9 times as likely as dogs with T-cell phenotype to have a CR to chemotherapy in multicentric lymphomas (P = 0.089). Clinical substage, P-glycoprotein expression prior to chemo-therapy, and response to therapy were significantly associated with the survival time. Tumor lineage was determined in 66 lymphomas by IHC and PCR methods. As a result, multicentric lymphomas comprised 78.6% (44/56) B-cell and 12.5% (7/56) T-cell lymphomas, and 5 dogs (5/56; 8.9%) remained undetermined. All the 10 cutaneous lymphomas were of T-cell phenotype. Dual phenotype and genotype were separately found in two multicentric lymphomas. Overall, a higher sensitivity of IHC immuno-phenotyping than PCR clonality assay (93.4% versus 87.0%) in the determination of lineage was demonstrated in all lymphomas in the present study.
其他識別: U0005-0607201114203100
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