意义不确定的 T 细胞克隆。盗贼克隆体什么时候会变得危险?
T-cell clones of uncertain significance. When is the rogue clone dangerous?
发表日期:2024 Oct 03
作者:
Gianpietro Semenzato, Antonella Teramo, Giulia Calabretto, Renato Zambello
来源:
HAEMATOLOGICA
摘要:
T 细胞大颗粒淋巴细胞克隆随着时间的推移持续存在,并且表现出与 T 细胞大颗粒淋巴细胞白血病 (T-LGLL) 非常相似的分子和免疫表型特征,在缺乏任何支持 T 细胞诊断的临床或实验室特征的个体中可以检测到。 -细胞恶性肿瘤。这种情况代表了一种潜在的前体状态,称为意义不确定的 T 细胞克隆 (T-CUS)。 T-CUS 代表了广泛的克隆性 T 大颗粒淋巴细胞增殖中更为良性的极端,强调需要进行适当的多参数诊断评估,以避免误诊 T 细胞肿瘤。这种方法应该克服将数值截止作为区分良性病症和相关恶性肿瘤的唯一标准的问题。特别是,基因组异常可能会前瞻性地识别出有发展为全面性 T 细胞恶性肿瘤风险的个体。我们在此讨论这些 T 细胞克隆在健康和疾病状态下的重要性,建议通过分子测定来追踪疾病的早期阶段。
T cell large granular lymphocyte clones that persist over time and that exhibit molecular and immunophenotypic features closely resembling those of T-cell Large Granular Lymphocyte Leukemia (T-LGLL) may be detectable in individuals who lack any clinical or laboratory features supporting a diagnosis of T-cell malignancy. This condition represents a potential precursor state termed T cell clones of uncertain significance (T-CUS). T-CUS represents the even more benign extreme of the wide spectrum of clonal T- large granular lymphocyte proliferations, emphasizing the need for an appropriate multiparametric diagnostic assessment that avoids misdiagnosis of T-cell neoplasia. This approach should overcome the numerical cut-offs as the sole criteria to differentiate the benign condition from the related malignancies. In particular, genomic aberrancies might prospectively identify individuals who are at risk of progression to full blown T-cell malignancy. We herein discuss the significance of these T cell clones in both healthy and disease states suggesting molecular assays for tracking early steps of disease.