广西地区鼻NK/T细胞淋巴瘤的临床病理特点及与EB病毒的关系

THE CLINICOPATHOLOGIC FEATURES OF NASAL NK/T-CELL LYMPHOMA IN GUANGXI REGION AND THEIR ASSOCIATION WITH EBV

目的:研究广西地区鼻NK/T细胞淋巴瘤的临床病理特点及与EB病毒(EBV)的关系。方法:筛选鼻NK/T细胞淋巴瘤89例,观察形态学及免疫组织化学特点;同时,应用手工显微切割挖取小片肿瘤组织,用PCR方法检测EBV的潜伏膜蛋白-1(LMP-1)基因序列。结果:本组52例(58.43%)的患者其肿瘤组织内有凝固性坏死,37例(41.57%)有血管中心性浸润,18例(20.22%)有血管破坏;本组有36例(40.45%)的患者其瘤细胞呈多形性特点。免疫组化阳性率CD2为84.26%,CD56为95.51%,GranzymeB为84.26%。用手工显微切割联合PCR检测LMP-1基因,NK/T细胞淋巴瘤阳性率为69.66%,与鼻咽癌中检测结果60.0%比较无明显差异(P>0.05),而与B细胞性淋巴瘤5%、鼻咽部慢性炎黏膜组织10%比较,差异有统计学意义(P<0.05)。结论:鼻NK/T细胞淋巴瘤是广西地区较常见的淋巴瘤亚型,瘤细胞呈多形性特点,常伴有凝固性坏死、血管中心性浸润和血管破坏。最典型的免疫表型是CD2、CD56和GranzymeB阳性。LMP-1基因在鼻NK/T细胞淋巴瘤中的高检出率,提示EBV可能对该淋巴瘤的发生、发展起作用。

Objective：To detect the clinicopathologic features of nasal NK/T-cell lymphoma in Guangxi and their association with Epstein Barr virus （EBV）. Methods： The clinicopathologic features, immunophenotypes of 89 patients with nasal NK/T-cell lymphoma were analyzed. These cases were hand-made microdis-section, then, were detected the specific DNA sequence of LMP-1 by polymerase chain reaction（PCR）. Result： Of the cases, Coagulative necrosis is found in about 52/89（58.43%）; angiocentric is found in 37/89 （41.57%） ; angiodestructive is found in 18/89（20.22%）. The feature of tumor cells in 36/89（40.45%） of the cases is multiform. Of the cases, CD2 expression is detectable in 75/89（84.26%） ; CD56 in 85/89（95. 51%）; GranzymeBin 75/89（84.26%）. Combine hand-made microdissection with PCR to detecte LMP-1.The positive rate of LMP-1 in NK/T-cell lymphoma was 62/89 （69.66%）, in nasopharyngeal carcinoma was 18/30 （60%）, in B non-hodgkin＇s lymphoma was 1/20（5%）, in nasopharynx mucosa tissue was 2/20 （10% ）. There were no statistical differences between NK/T-cell lymphoma and nasopharyngeal carcinoma（ P 〉0.05）. Compared with B non-hodgkin＇s lymphoma and nasopharynx mucosa tissue, NK/T-cell lymphoma have higher positive rate, and the statistical differences is prominent （ P 〈0.05）. Conclusion： nasal NK/T-cell lymphoma is a common subtype of lymphoma in Guangxi region. The feature of tumor cells is multiform. Coagulative necrosis is very common. An angiocentric and angiodestructive growth pattern is frequently present. The most typical immunophenotypes of nasal NK/T-cell lymphoma is： CD2, D56 and Granzyme B. The detection rate of LMP-1 is high in nasal NK/T-cell lymphoma, suggesting a probable pathogenic role of the virus.