RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Clinical features and prognosis of chronic natural killer cell lymphoproliferative disorders.
Clinical features and prognosis of chronic natural killer cell lymphoproliferative disorders.
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大多数 CLPD-NK 患者进展惰性,预后良好,而部分患者进展为 ANKL 并合并噬血细胞综合征后预后较差。异常 NK 细胞侵犯中心提示 ANKL 发展的可能性高,免疫抑制剂和激素是该病的有效治疗方法。
分析慢性NK细胞淋巴增殖性疾病(CLPD-NK)的当前治疗现状及预后回归。
我们回顾性分析了2016年9月至2022年9月期间在我院接受治疗的18例CLPD-NK患者的临床特征、治疗及预后。
共纳入18例患者:3例患者接受化疗,5例患者接受免疫相关治疗,1例患者仅接受糖皮质激素治疗,5例患者接受粒细胞集落刺激因子、输血治疗或抗感染治疗,随后观察和随访,4例患者未接受治疗仅观察。15例患者存活,其中2例患者达到完全缓解(CR),7例患者达到部分缓解(PR),其中1例患者进展为侵袭性NK细胞白血病(ANKL),经多线治疗后持续缓解;3例患者未复查,其中1例患者仍处于活动性疾病状态,3例患者在治疗期间发生噬血细胞综合征并最终死亡,其中1例患者EBV表达阳性。5年总生存率为83%。
To analyze the current treatment status and prognostic regression of the chronic NK cell lymphoproliferative disorder (CLPD-NK).
We retrospectively analyzed the clinical features, treatment and prognosis of 18 patients with CLPD-NK who were treated at our Hospital between September 2016 and September 2022.
Eighteen patients were included: three patients were treated with chemotherapy, five patients underwent immune-related therapy, one patient was treated with glucocorticoids alone, five patients were administered granulocyte colony-stimulating factor, blood transfusion therapy, or anti-infection therapy, followed by observation and follow-up, and four patients were observed without treatment. Fifteen patients survived, including two patients who achieved complete remission (CR) and seven patients who achieved partial remission (PR), of whom one patient progressed to Aggressive NK-cell leukemia (ANKL) and sustained remission after multiple lines of treatment; three patients were not reviewed, of which one patient was still in active disease, three patients developed hemophagocytic syndrome during treatment and eventually died, one of them had positive Epstein-Barr virus (EBV) expression. The 5-years overall survival rate was 83%.
Most patients with CLPD-NK have inert progression and a good prognosis, whereas some patients have a poor prognosis after progressing to ANKL and combined with hemophagocytic syndrome. Abnormal NK cells invading the center suggest a high possibility of ANKL development, and immunosuppressants and hormones are effective treatments for this disease.
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