鼻腔鼻窦非霍奇金淋巴瘤免疫表型及其与EB病毒感染的关系(英文)

Correlation of Immunophenotype of Sinonasal Non-Hodgkin's Lymphoma to Epstein-Barr Virus Infection

背景与目的:鼻腔鼻窦非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)的患病率和免疫表型组成具有地域性差异。本研究探讨中国广州地区57例鼻腔鼻窦NHL免疫表型及其与EB病毒(Epstein-Barrvirus,EBV)感染的关系。方法:收集2000年4月1日至2006年10月31日中山大学肿瘤防治中心病理科57例鼻腔鼻窦NHL标本。免疫组化染色确定免疫表型,EBER原位杂交及PCR检测EBV感染情况。结果:在同期诊断的1412例NHL中,71例(5.03%)发生于鼻腔鼻窦,其中仅有57例适用于本研究。57例鼻腔鼻窦NHL患者中,男性38例,女性19例,年龄3～75岁,中位年龄50岁;44例(77.19%)为鼻型NK/T细胞淋巴瘤,其中37例(84.09%)为EBV+/CD56+NK细胞肿瘤,7例(15.91%)为EBV+/CD56-细胞毒性T细胞表型;11例(19.30%)为B细胞淋巴瘤,其中6例为弥漫大B表型,2例为Burkitt(Burkitt样)淋巴瘤(EBV+),1例为髓外浆细胞瘤(EBV+),1例为MALT淋巴瘤(EBV-),1例为小淋巴细胞性淋巴瘤(EBV-);2例(3.51%)为外周T细胞淋巴瘤(EBV-)。37例适用DNA检测的病例中,25例(67.57%)感染缺失型LMP1(del-LMP1)EBV株,12例(32.43%)感染野生型LMP1(wt-LMP1)EBV株。结论:鼻腔鼻窦NHL最常见的类型为鼻型NK/T细胞淋巴瘤,可进一步分为EBV+/CD56+NK细胞及EBV+/CD56-细胞毒性T细胞表型。NK/T细胞淋巴瘤均感染了EBV,EBV株主要为del-LMP1型。

BACKGROUND ＆ OBJECTIVE： There are differences in the prevalence rate and composition of immunophenotypes of sinonasal non-Hodgkin＇s lymphoma （NHL） depending on the geography. This study was to investigate the immunophenotypes of sinonasal NHLs and their relationship to Epstein-Barr virus （EBV） infection in Guangzhou, China. METHODS. Fiftyseven NHL samples of the sinonasal region were collected from the Department of Pathology, Cancer Center of Sun Yat-sen University from Apr. 1, 2000 to Oct. 31, 2006. HE staining and immunohistochemical staining were performed. Both Epstein-Barr virus-encoded small RNA （EBER） hybridization and PCR were applied to identify EBV infection. RESULTS： Seventy-one sinonasal NHLs were found in all 1 412 NHLs （71/1 412, 5.03%）. Only 57 out of the 71 NHL biopsy tissues were suitable for this study. The median age of the patients was 50 years （ranged from 3 to 75 years）. There were 38 males and 19 females. Forty-four sinonasal NHLs （44/57, 77.19%） were NK/T-cell lymphoma, nasal type, all of which were infected with EBV. Among them, 37 patients （84.09%） appeared to be NK-cell neoplasm （EBV＋/CD56＋）, and 7 cases （15.91%） showed an EBV＋/CD56- cytotoxic T-cell phenotype. Eleven cases （11/57, 19.30%） were B-cell lymphoma. There were 6 cases of diffuse large B-cell immunophenotype, 2 cases of Burkitt （Burkitt-like） lymphoma （EBV＋）, 1 case of extramedullary plasmacytoma （EBV＋）, 1 case of MALT- lymphoma （EBV-）, and 1 case of small lymphocytic lymphoma （EBV-）. Only 2 cases （2/57, 3.51%; EBV-） were peripheral T-cell lymphoma, unspecified. The del-LMP1 EBV strain harbored in 25 out of 37 available DNA samples of NK/T-cell lymphoma （25/37, 67.57%）; and the wt-LMP1 EBV strain was found in 12 samples （12/37, 32.43%）. CONCLUSION. The most common sinonasal NHL is the NK/T-cell lymphoma, nasal type, which can be further subclassified into NK-cell neoplasm （EBV ＋/CD56 ＋ ） and EBV ＋/CD56- cytotoxic T-cell phenotype. The major EBV strain in NK/T-cell lymphomas is del-LMP1 strain.