年轻人霍奇金淋巴瘤亚型特点及肿瘤细胞EB病毒和Bcl-2蛋白的表达及其意义

Subtype characteristics of Hodgkin lymphoma in young adults and expressions of Epstein-Barr virus and Bcl-2 protein in tumor cells and significance

目的:研究EB病毒(EBV)与Bcl-2蛋白在年轻人霍奇金淋巴瘤肿瘤细胞中的表达,阐明二者之间的关系。方法:复查48例16～36岁霍奇金淋巴瘤患者的临床和病理资料,应用免疫组织化学方法检测肿瘤细胞中CD30、CD15、CD45、LMP-1和Bcl-2蛋白的表达并进行组织学分型;采用组织芯片的原位杂交方法检测EBV的表达,并对EBV和Bcl-2表达之间的关系进行统计学分析。结果:按照WHO 2008年分类标准,本组均为经典霍奇金淋巴瘤。其中混合细胞型42.67%(20/48),结节硬化型27.08%(13/48),富于淋巴细胞型25.00%(12/48),淋巴细胞减少型5.25%(3/48);EBV表达率为25%(12/48),在各亚型中依次为:淋巴细胞减少型66.67%(2/3),混合细胞型30.00%(6/20),富于淋巴细胞型25.00%(3/12),结节硬化型7.69%(1/13);EBV阳性率与患者性别、年龄及组织学亚型无关联(P>0.05)。Bcl-2蛋白的表达率为64.58%(31/48),在各亚型中依次为:结节硬化型84.62%(11/13),混合细胞型65.00%(13/20),富于淋巴细胞型50.00%(6/12),淋巴细胞减少型33.33%(1/3);Bcl-2蛋白的表达与患者性别、年龄和组织学亚型以及EBV的表达无关联(P>0.05)。结论:本组年轻人霍奇金淋巴瘤组织学分型以混合细胞型为主;EBV和Bcl-2蛋白的表达率均与性别、年龄和组织学亚型无关联,而且EBV表达与Bcl-2蛋白表达无关联。

Objective To study the expressions of Epstein-Barr virus(EBV) and Bcl-2 protein in Hodgkin and Reed-Sternberg(HRS) cells of Hodgkin lymphoma(HL) in young adults and clarify the relationship between them.Methods The clinical and pathological data of 48 patients with HL between 16 and 36 years old were collected and reviewed.The immunohistochemical method was employed to detect the expressions of CD30,CD15,CD45,LMP-1 and Bcl-2 in HRS cells of young patients with HL.In situ hybridization at tissue chip was used to detect the expression of EBV encoded small RNAs(EBER1 and EBER2).Statistical analysis was done to investigate the association between EBV and Bcl-2 expression.Results According to WHO 2008 classification criteria,no nodular lymphocyte predominant Hodgkin lymphoma(NLPHL) was found in this group,all the cases were classical Hodgkin lymphoma(CHL),among which mixed cellularity classical Hodgkin lymphoma(MCCHL) accounted for 42.67%(20/48),nodular sclerosis classical Hodgkin lymphoma(NSCHL) 27.08%(13/48),lymphocyte-rich classical Hodgkin lymphoma(LRCHL) 25.00%(12/48),lymphocyte-depleted classical Hodgkin lymphoma(LDCHL) 5.25%(3/48).The positive rate of EBV was 25.00% in all the 48 cases,and 66.67%(2/3),30.00%(6/20),25.00%(3/12),7.69%(1/13) in LDCHL,MCCHL,LRCHL and NSCHL,respectively;but not associated with gender,age and histological subtype of patients(P>0.05).The Bcl-2 protein was expressed in 64.58% of the 48 cases,its positive rates were 84.62%(11/13),65.00%(13/20),50.00%(6/12),and 33.33%(1/3)in NSCHL,MCCHL,LRCHL,and LDCHL,respectively;and not relevant to gender,age,EBV expression and histological subtype of patients(P>0.05).Conclusion MCCHL is predominant in the four CHL subtypes.The positive rates of EBV and Bcl-2 protein expression are not related to gender,age and histological subtype of patients,and no relationship is found between EBV and Bcl-2 protein expression.