fusion genes

融合基因
  • 文章类型: Journal Article
    前列腺癌(PCa)是一种高度异质性的疾病,包括各种分子和临床病理亚型。融合基因在PCa的发生和发展中起促进作用。我们根据融合基因将PCa样品分为ETS转录因子融合阳性和融合阴性亚型。这种分型方法与PCa的表观基因组DNA甲基化谱密切相关,每个样本群包括85%以上的患者。我们对ETS家族融合基因在染色体上的分布进行了分析,阅读框架内的融合模式,和结构域的预测。其中,ETS家族相关融合基因发生频率最高的是21号染色体。与亲本基因相比,融合基因展示了新的结构域,如IG_like,最常见的融合模式是帧外融合。高甲基化CpG位点的甲基化水平与其相应mRNA的表达水平之间的相关性表明CD8A和B3GNT5(分别具有-0.388和-0.253的相关性)可以作为PCa的潜在预后标志物。
    Prostate cancer (PCa) is a highly heterogeneous disease, encompassing various molecular and clinical pathological subtypes. Fusion genes play a facilitating role in the occurrence and progression of PCa. We categorized PCa samples into the ETS family of transcription factors fusion positive and fusion negative subtypes based on fusion genes. This subtyping method is closely related to the epigenomic DNA methylation profiles of PCa, with each sample cluster including more than 85% of the patients. We conducted an analysis of the distribution of the ETS family fusion genes on chromosomes, fusion modes within reading frames, and predictions of structural domains. Among these, the highest frequency of the ETS family related fusion genes occurred on chromosome 21. Compared to the parental genes, fusion genes exhibited new structural domains, such as IG_like, and the most common fusion mode was out-of-frame fusion. The correlation between the methylation levels of hypermethylated CpG sites and the expression levels of their corresponding mRNAs indicates that CD8A and B3GNT5 (with correlations of - 0.388 and - 0.253, respectively) could serve as potential prognostic markers for PCa.
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  • 文章类型: Journal Article
    以前,我们报道了人类原发性(SW480)和转移性(SW620)结直肠(CRC)细胞释放三类膜包裹的细胞外囊泡(EV);中体残留物(MBR),外泌体(Exos),和微粒(MPs)。我们报道了MBR在蛋白质水平上的分子差异。为了获得对MBR的进一步生化见解,Exos,议员及其在儿童权利委员会中的新作用,我们表演了,在这里报告,第一次,使用下一代RNA测序技术对这三个EV类进行全面的转录组和长非编码RNA测序分析和融合基因鉴定。差异转录表达分析显示,与Exos和MPs相比,MBR具有不同的转录组学特征,具有高度富集的线粒体转录物lncRNA/假基因转录物,这些转录物预测与核糖核蛋白复合物结合,剪接体,和RNA/应激颗粒蛋白。这项研究的一个重要发现是与Exos相比,MBR中几种融合基因的高度富集,议员们,和来自其亲本细胞的细胞裂解物如MSH2(基因编码的DNA错配修复蛋白MSH2)。这表明潜在的EV液体活检目标用于癌症检测。重要的是,在源自SW480(EGFR)和SW620(MET和MACCA1)细胞系的EV类别中发现的癌症进展相关转录本的表达反映了它们的亲本细胞类型.我们的研究是MBR(包括Exos和MPs)中的RNA和融合基因组成的报告,这些成分可能会对癌症进展中的EV功能产生影响,并使用基于EV的RNA/融合基因候选物进行癌症生物标志物的检测。
    Previously, we reported that human primary (SW480) and metastatic (SW620) colorectal (CRC) cells release three classes of membrane-encapsulated extracellular vesicles (EVs); midbody remnants (MBRs), exosomes (Exos), and microparticles (MPs). We reported that MBRs were molecularly distinct at the protein level. To gain further biochemical insights into MBRs, Exos, and MPs and their emerging role in CRC, we performed, and report here, for the first time, a comprehensive transcriptome and long noncoding RNA sequencing analysis and fusion gene identification of these three EV classes using the next-generation RNA sequencing technique. Differential transcript expression analysis revealed that MBRs have a distinct transcriptomic profile compared to Exos and MPs with a high enrichment of mitochondrial transcripts lncRNA/pseudogene transcripts that are predicted to bind to ribonucleoprotein complexes, spliceosome, and RNA/stress granule proteins. A salient finding from this study is a high enrichment of several fusion genes in MBRs compared to Exos, MPs, and cell lysates from their parental cells such as MSH2 (gene encoded DNA mismatch repair protein MSH2). This suggests potential EV-liquid biopsy targets for cancer detection. Importantly, the expression of cancer progression-related transcripts found in EV classes derived from SW480 (EGFR) and SW620 (MET and MACCA1) cell lines reflects their parental cell types. Our study is the report of RNA and fusion gene compositions within MBRs (including Exos and MPs) that could have an impact on EV functionality in cancer progression and detection using EV-based RNA/ fusion gene candidates for cancer biomarkers.
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  • 文章类型: Journal Article
    锌指蛋白384(ZNF384)重排定义了B细胞急性淋巴细胞白血病(B-ALL)的一种新亚型。代表可测量的残留病的ZNF384融合转录物水平的预后意义仍有待探索。通过实时定量聚合酶链反应在57名成年B-ALL患者的诊断中筛选出ZNF384融合蛋白,并在治疗期间连续监测其转录水平。在达到完全缓解时,ZNF384融合转录水平的降低对生存率没有显著影响,而其≥2.5-log减少与第1期巩固(p=0.022和=0.0083)和第2期巩固(p=0.0025和=0.0008)后更高的无复发生存率(RFS)和总生存率(OS)显著相关.与单纯化疗相比,异基因造血干细胞移植(allo-HSCT)在第1期巩固(p<0.0001和=0.0002)和第2期巩固(p=0.0003和=0.019)后显著改善<2.5-log减少患者的RFS和OS,而在降低≥2.5-log的患者中没有显着影响(均p>0.05)。第1期和第2期巩固后的ZNF384融合转录水平强烈预测复发和生存,并可能指导成人B-ALL是否接受allo-HSCT。
    Zinc finger protein 384 (ZNF384) rearrangement defined a novel subtype of B-cell acute lymphoblastic leukemia (B-ALL). The prognostic significance of ZNF384 fusion transcript levels represented measurable residual disease remains to be explored. ZNF384 fusions were screened out in 57 adult B-ALL patients at diagnosis by real-time quantitative polymerase chain reaction and their transcript levels were serially monitored during treatment. The reduction of ZNF384 fusion transcript levels at the time of achieving complete remission had no significant impact on survival, whereas its ≥2.5-log reduction were significantly associated with higher relapse free survival (RFS) and overall survival (OS) rates after course 1 consolidation (p = 0.022 and = 0.0083) and course 2 consolidation (p = 0.0025 and = 0.0008). Compared with chemotherapy alone, allogeneic hematopoietic stem cell transplantation (allo-HSCT) significantly improved RFS and OS of patients with <2.5-log reduction after course 1 consolidation (p < 0.0001 and = 0.0002) and course 2 consolidation (p = 0.0003 and = 0.019), whereas exerted no significant effects in patients with ≥2.5-log reduction (all p > 0.05). ZNF384 fusion transcript levels after course 1 and course 2 consolidation strongly predict relapse and survival and may guide whether receiving allo-HSCT in adult B-ALL.
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  • 文章类型: Journal Article
    纤维肉瘤,源自成纤维细胞,代表一种恶性肿瘤,可以在所有性别和年龄组中表现出来。融合基因在人类癌症中尤为普遍,特别是在纤维肉瘤的亚型中,它们在肿瘤发生中发挥了巨大的驱动力。许多融合基因是引发这种疾病发作的致病机制的基础。此外,融合基因类型谱与纤维肉瘤的表型表达密切相关,赋予融合基因不仅是纤维肉瘤的有希望的诊断指标,而且是其亚分类的关键基础。同时,越来越多的融合基因编码的嵌合蛋白已被证实为治疗纤维肉瘤的特异性靶标,从而显著提高患者预后。这篇综述全面描述了纤维肉瘤融合基因形成的机制。融合基因的谱系,用于检测纤维肉瘤内融合基因的方法,以及由纤维肉瘤域内的融合基因驱动的靶向治疗干预的前景。
    Fibrosarcoma, originating from fibroblast cells, represents a malignant neoplasm that can manifest across all genders and age groups. Fusion genes are notably prevalent within the landscape of human cancers, particularly within the subtypes of fibrosarcoma, where they exert substantial driving forces in tumorigenesis. Many fusion genes underlie the pathogenic mechanisms triggering the onset of this disease. Moreover, a close association emerges between the spectrum of fusion gene types and the phenotypic expression of fibrosarcoma, endowing fusion genes not only as promising diagnostic indicators for fibrosarcoma but also as pivotal foundations for its subcategorization. Concurrently, an increasing number of chimeric proteins encoded by fusion genes have been substantiated as specific targets for treating fibrosarcoma, consequently significantly enhancing patient prognoses. This review comprehensively delineates the mechanisms behind fusion gene formation in fibrosarcoma, the lineage of fusion genes, methodologies employed in detecting fusion genes within fibrosarcoma, and the prospects of targeted therapeutic interventions driven by fusion genes within the fibrosarcoma domain.
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  • 文章类型: Journal Article
    背景:越来越多的患者被诊断为肺腺癌,但这些患者在提高预后结局和提高生存率方面仍有有限进展.基因组不稳定被认为是一个促成因素,因为它使癌症的其他标志获得功能能力,从而允许癌细胞存活,增殖,和传播。尽管基因组不稳定在癌症发展中很重要,很少有研究探讨与肺腺癌基因组不稳定性相关的预后特征.方法:在研究中,我们将癌症基因组图谱数据库中的397例肺腺癌患者随机分为训练组(n=199)和试验组(n=198).通过计算训练组中每位患者的基因组改变的累积计数,我们区分了前25%和后25%的患者。然后,我们比较了它们的基因表达,以鉴定与基因组不稳定性相关的基因。接下来,我们使用单变量和多变量Cox回归分析来确定预后特征.我们还进行了Kaplan-Meier生存分析和对数秩检验,以评估所鉴定的预后特征的性能。在测试组中进一步验证了签名的性能,在癌症基因组图谱数据集中,和外部数据集。我们还进行了与时间相关的受试者操作特征分析,以将我们的特征与已建立的预后特征进行比较,以证明其潜在的临床价值。结果:我们确定了GULPsig,其中包括IGF2BP1,IGF2BP3,SMC1B,CLDN6和LY6K,作为42个基因组不稳定相关基因的肺腺癌患者的预后标志。根据GULPsig风险模型的风险评分,根据Kaplan-Meier生存分析和log-rank检验的结果,我们成功地将患者分为高危组和低危组.我们进一步验证了GULPsig作为独立预后标志的性能,并观察到它优于已建立的预后标志。结论:我们为探索基因组不稳定性的临床应用提供了新的见解,并将GULPsig鉴定为肺腺癌患者的潜在预后特征。
    Background: An increasing number of patients are being diagnosed with lung adenocarcinoma, but there remains limited progress in enhancing prognostic outcomes and improving survival rates for these patients. Genome instability is considered a contributing factor, as it enables other hallmarks of cancer to acquire functional capabilities, thus allowing cancer cells to survive, proliferate, and disseminate. Despite the importance of genome instability in cancer development, few studies have explored the prognostic signature associated with genome instability for lung adenocarcinoma. Methods: In the study, we randomly divided 397 lung adenocarcinoma patients from The Cancer Genome Atlas database into a training group (n = 199) and a testing group (n = 198). By calculating the cumulative counts of genomic alterations for each patient in the training group, we distinguished the top 25% and bottom 25% of patients. We then compared their gene expressions to identify genome instability-related genes. Next, we used univariate and multivariate Cox regression analyses to identify the prognostic signature. We also performed the Kaplan-Meier survival analysis and the log-rank test to evaluate the performance of the identified prognostic signature. The performance of the signature was further validated in the testing group, in The Cancer Genome Atlas dataset, and in external datasets. We also conducted a time-dependent receiver operating characteristic analysis to compare our signature with established prognostic signatures to demonstrate its potential clinical value. Results: We identified GULPsig, which includes IGF2BP1, IGF2BP3, SMC1B, CLDN6, and LY6K, as a prognostic signature for lung adenocarcinoma patients from 42 genome instability-related genes. Based on the risk score of the risk model with GULPsig, we successfully stratified the patients into high- and low-risk groups according to the results of the Kaplan-Meier survival analysis and the log-rank test. We further validated the performance of GULPsig as an independent prognostic signature and observed that it outperformed established prognostic signatures. Conclusion: We provided new insights to explore the clinical application of genome instability and identified GULPsig as a potential prognostic signature for lung adenocarcinoma patients.
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  • 文章类型: Journal Article
    锌指蛋白384(ZNF384)编码可作为转录因子起作用的C2H2型锌指蛋白。急性淋巴细胞白血病(ALL)中的ZNF384重排最早于2002年报道。在ALL中检测到超过19种不同的ZNF384融合伴侣。这些包括E1A结合蛋白P300(EP300),CREB结合蛋白(CREBBP),转录因子3(TCF3),TATA-box结合蛋白相关因子15(TAF15),尤因肉瘤断点区1基因(EWSR1),富含AT的含相互作用域的蛋白1B(ARID1B),SWI/SNF相关,矩阵关联,肌动蛋白依赖性染色质调节剂,亚科A,成员4(SMARCA4),SWI/SNF相关,矩阵关联,肌动蛋白依赖性染色质调节剂,亚科A,成员2(SMARCA2),协同伽玛(SYNRG),网格蛋白重链(CLTC),骨形态发生蛋白2-诱导激酶(BMP2K),挤压B样蛋白(NIPBL),激酶锚定蛋白8(AKAP8),染色体11开放阅读框74(C11orf74),DEAD-Box解旋酶42(DDX42),ATP合酶F1亚基γ(ATP2C1),优色组蛋白赖氨酸甲基转移酶1(EHMT1),Testic表达41(TEX41),等。诊断为患有ZNF384重排的ALL的患者通常预后良好。机制,性能,急性淋巴细胞白血病中不同ZNF384重排的特征已经得到了很好的评估。
    Zinc finger protein 384 (ZNF384) encodes a C2H2-type zinc finger protein that can function as a transcription factor. ZNF384 rearrangement in acute lymphoblastic leukemia (ALL) was first reported in 2002. More than 19 different ZNF384 fusion partners have been detected in ALL. These include E1A-binding protein P300 (EP300), CREB-binding protein (CREBBP), transcription factor 3 (TCF3), TATA-box binding protein associated factor 15 (TAF15), Ewing sarcoma breakpoint region 1 gene (EWSR1), AT-rich interactive domain-containing protein 1B (ARID1B), SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily A, member 4 (SMARCA4), SWI/SNF related, matrix associated, actin dependent regulator of chromatin, subfamily A, member 2 (SMARCA2), synergin gamma (SYNRG), clathrin heavy chain (CLTC), bone morphogenic protein 2-inducible kinase (BMP2K), Nipped-B-like protein (NIPBL), A Kinase Anchoring Protein 8 (AKAP8), Chromosome 11 Open Reading Frame 74 (C11orf74), DEAD-Box Helicase 42 (DDX42), ATP Synthase F1 Subunit Gamma (ATP2C1), Euchromatic Histone Lysine Methyltransferase 1 (EHMT1), Testic Expressed 41 (TEX41), etc. Patients diagnosed with ALL harboring ZNF384 rearrangements commonly had a good prognosis. The mechanisms, performance, and features of different ZNF384 rearrangements in acute lymphoblastic leukemia have been well evaluated.
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  • 文章类型: Journal Article
    背景:基因组改变在癌症的发展中起重要作用。我们探讨了蛋白质编码基因和转录变化对台湾肝细胞癌(HCC)患者临床和分子改变的影响。
    方法:我们分析了147个HCC的全外显子组测序和100个RNA测序数据集,并将它们与癌症基因组图谱(TCGA)-肝细胞癌队列进行比较,并开发了一组81个凋亡相关基因用于分子分类。
    结果:TERT(50%),TP53(25%),CTNNB1(14%),ARID1A(12%),和KMT2C(11%)是癌症相关基因最常见的遗传改变。ALDH2和KMT2C在我们队列中的突变频率远高于TCGA,而CTNNB1仅在14%的台湾患者中发现。还观察到APOBEC突变特征和与草药药物相关的马兜铃酸相关特征中ALDH2的高种系突变率。当我们使用凋亡相关基因进行分子分类时,确定了HCC的A和B组。后一组,生存结果较差,有更多的aDC,CD4+Tem,巨噬细胞M2,NKT,浆细胞,和Th1细胞,和较少的CD4+记忆T细胞,CD8+Tcm,cDC,iDC,和Th2细胞,以及更多的染色体间融合基因。代谢组学分析显示有54例HBV感染。此外,我们发现HBV整合的主要靶基因是ALB。
    结论:在我们的台湾HCC患者中观察到独特的基因组改变。使用凋亡相关基因的分子分类可能导致HCC的新治疗方法。
    BACKGROUND: Genomic alterations play important roles in the development of cancer. We explored the impact of protein-coding genes and transcriptomic changes on clinical and molecular alterations in Taiwanese hepatocellular carcinoma (HCC) patients.
    METHODS: We analyzed 147 whole-exome sequencing and 100 RNA sequencing datasets of HCC and compared them with The Cancer Genome Atlas (TCGA)-Liver Hepatocellular Carcinoma cohort and develop a panel of 81 apoptosis-related genes for molecular classification.
    RESULTS: TERT (50%), TP53 (25%), CTNNB1 (14%), ARID1A (12%), and KMT2C (11%) were the most common genetic alterations of cancer-related genes. ALDH2 and KMT2C mutated at much higher frequencies in our cohort than in TCGA, whereas CTNNB1 was found only in 14% of our Taiwanese patients. A high germline mutation rate of ALDH2 in the APOBEC mutational signature and herb drug-related aristolochic acid-associated signature was also observed. Groups A and B of HCC were identified when we used apoptosis-related genes for molecular classification. The latter group, which had poorer survival outcomes, had significantly more aDC, CD4+ Tem, macrophages M2, NKT, plasma cells, and Th1 cells, and less CD4+ memory T cells, CD8+ Tcm, cDC, iDC, and Th2 cells, as well as more inter-chromosome fusion genes. Metatranscriptomic analysis revealed 54 cases of HBV infection. Moreover, we found that the main target gene of HBV integration is ALB.
    CONCLUSIONS: Unique genomic alterations were observed in our Taiwanese HCC patients. Molecular classification using apoptosis-related genes could lead to new therapeutic approaches for HCC.
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  • 文章类型: Journal Article
    融合基因是染色体易位的产物,可产生失调的伴侣基因或具有新特性的嵌合融合蛋白。并显著促进白血病的发展和临床危险分层。然而,在临床实验室环境中,同时检测数百个融合基因一直是一个挑战。在本研究中,共182例儿童白血病患者通过使用新的基因组DNA筛选融合基因,而不是RNA-,基于下一代测序(NGS)方法。这涉及多重靶向捕获测序方法与270个融合基因的检测组(MTCS-270)与基于RNA的多重逆转录PCR技术与57个融合基因的检测组(MRTP-57)的比较。MRTP-57已在北京Hightrust诊断学的临床实验室中得到了很好的建立,有限公司(北京,中国)用于早期白血病诊断,并作为本研究的控制技术。在该系列中,MTCS-270和MRTP-57融合基因阳性检出率分别为50.0%(91/182)和41.8%(76/182),分别,表明MTCS-270在整体检测灵敏度上优于MRTP-57。具体来说,MRTP-57检测到的所有融合基因也被MTCS-270鉴定,这清楚地表明MTCS-270具有可观的检测准确性。值得注意的是,在筛查的患者中,MTCS-270比MRTP-57鉴定出更多具有融合基因的样品,说明MTCS-270具有更广泛的融合基因检测范围。本研究提供了坚实的证据,表明这种基于DNA的NGS方法可以与其他成熟的分子细胞遗传学方法一起用作白血病治疗的潜在检测工具。据我们所知,代表通过基因组NGS进行的最大的白血病融合基因鉴定分析。
    Fusion genes are products of chromosomal translocations that generate either a dysregulated partner gene or a chimeric fusion protein with new properties, and contribute significantly to leukemia development and clinical risk stratification. However, simultaneous detection of several hundreds of fusion genes has always been a challenge in a clinical laboratory setting. In the present study, a total of 182 pediatric patients with leukemia were screened for fusion genes by employing a novel genomic DNA-, instead of RNA-, based next-generation sequencing (NGS) method. This involved the comparison of the multiply targeted capture sequencing method with a detection panel of 270 fusion genes (MTCS-270) with an RNA-based multiplex reverse transcription-PCR technique with a detection panel of 57 fusion genes (MRTP-57). MRTP-57 has been well established in the clinical lab at Beijing Hightrust Diagnostics, Co. (Beijing, China) for an up-front leukemia diagnosis and served as the control technique in the present study. In the series, MTCS-270 and MRTP-57 yielded a positive fusion gene detection rate of 50.0% (91/182) and 41.8% (76/182), respectively, indicating an advantage of MTCS-270 over MRTP-57 in overall detection sensitivity. Specifically, all the fusion genes detected by MRTP-57 were also identified by MTCS-270, clearly signifying the respectable detection accuracy of MTCS-270. Notably, across the patients screened, MTCS-270 identified more samples with fusion genes than MRTP-57, illustrating a broader fusion gene detection coverage by MTCS-270. The present study provides solid evidence that this DNA-based NGS approach can be used as a potential detection tool together with other well-established molecular cytogenetic methods for leukemia management, and to the best of our knowledge, represents the largest leukemia fusion gene identification analysis by genomic NGS.
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  • 文章类型: Journal Article
    背景:隆突性皮肤纤维肉瘤(DFSP)是一种罕见的皮肤肉瘤,其特征是局部侵袭和复发。RNA测序(RNA-seq)允许细胞RNA群体的资格,并提供有关转录状态的信息。然而,很少有研究全面分析DFSP转录数据。方法:使用来自接受Mohs显微手术的中国患者的14个DFSP样本与配对的非肿瘤性软组织进行RNA-seq分析。进行RNA-seq数据的差异表达分析和富集分析以鉴定融合基因,生物标志物,和DFSP的微环境特征。结果:本研究系统地描述了DFSP的转录组特征。首先,我们在1例纤维肉瘤转化的DFSP患者中进行了基因融合分析,并鉴定了一个新的FBN1-CSAD融合事件.然后,我们基于功能富集分析将TLK2鉴定为DFSP的生物标志物,并通过免疫组织化学染色和与公开数据的联合分析验证了其诊断DFSP的准确性。最后,微环境分析描述了DFSP中免疫和基质细胞的浸润特性。结论:这项研究表明,RNA-seq可以作为探索DFSP分子机制的有希望的策略。我们的研究结果为DFSP的准确诊断和治疗靶点提供了新的见解。
    Background: Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma characterized by local invasion and recurrence. RNA sequencing (RNA-seq) allows the qualification of cellular RNA populations and provides information on the transcriptional state. However, few studies have comprehensively analyzed DFSP transcriptional data. Methods: Fourteen DFSP samples with paired non-neoplastic soft tissue from Chinese patients undergoing Mohs micrographic surgery were used for RNA-seq analysis. Differential expression analysis and enrichment analysis for RNA-seq data were performed to identify fusion genes, biomarkers, and microenvironment characteristics of DFSP. Results: This study systemically describes the transcriptomic characteristics of DFSP. First, we performed gene fusion analysis and identified a novel FBN1-CSAD fusion event in a DFSP patient with fibrosarcomatous transformation. Then, we identified TLK2 as a biomarker for DFSP based on functional enrichment analysis, and validated its accuracy for diagnosing DFSP by immunohistochemical staining and joint analysis with public data. Finally, microenvironment analysis described the infiltration characteristics of immune and stromal cells in DFSP. Conclusion: This study demonstrates that RNA-seq can serve as a promising strategy for exploring molecular mechanisms in DFSP. Our results provide new insights into accurate diagnosis and therapeutic targets of DFSP.
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  • 文章类型: Journal Article
    Objective: To analyze the genetic landscape of multiple fusion genes in patients with de novo acute myeloid leukemia (AML) and investigate the characteristics of immunophenotypes and mutations. Methods: The results of multiple fusion genes from 4192 patients with de novo AML were retrospectively analyzed from 2016 to 2020. In addition, the immunophenotypical data and the mutational results from high-through put method were statistically investigated and correlated as well. Results: ①Among the 52 targets, 29 different types of fusion genes were detected in 1948 patients (46.47%) with AML, which demonstrated an \"exponential distribution\" . ② As the age increased, the number of patients with fusion gene increased first and then decreased gradually. The total incidence rate of fusion genes and MLL rearrangment in children were significantly higher than those in adults (69.18% vs 44.76%, 15.35% vs 8.36%) . ③The mutations involving FLT3 and RAS signaling pathway contributed most in patients with MLL rearrangment. ④No specific immunophenotypic characteristics were found in AML patients with MLL or NUP98 rearrangements. Conclusion: Nearly half of AML patients were accompanied by specific fusion gene expression, the proportions of different fusion genes in pediatric and adults patients were different by multiple PCR. The gene mutations and immunophenotype of these AML patients have certain rules.
    目的: 分析初诊急性髓系白血病(AML)患者融合基因表达情况,进一步探讨不同融合基因家族患者的免疫表型及基因突变的特点。 方法: 回顾性分析2016至2020年4192例初诊AML患者的多重融合基因筛查结果,并结合免疫表型分析以及高通量测序所获得的基因突变筛查结果,系统地进行差异性分析。 结果: ①4192例AML患者中1948例(46.47%)检出融合基因,共检出29种不同的融合基因,其阳性率呈现为\"幂律分布\"。②随着AML患者年龄增长,融合基因的阳性率先上升而后逐步下降。儿童患者融合基因总阳性率及MLL相关融合基因(MLL-FG)阳性率均显著高于成人患者(69.18%对44.76%,15.35%对8.36%)。③MLL-FG及NUP98相关融合基因(NUP98-FG)阳性患者伴随的基因突变均以FLT3及RAS信号通路相关基因为主。④MLL-FG及NUP98-FG阳性患者未见特异性的免疫表型特点。 结论: 采用多重PCR方法分析,近半数的AML患者伴有特异的融合基因表达,儿童和成人患者融合基因阳性类型构成比例存在差异。不同融合基因阳性AML患者常见的分子突变、免疫表型有一定规律。.
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