EB病毒相关的NK细胞淋巴增殖性疾病的诊断和治疗

Diagnosis and treatment of Epstein-Barr virus-associated natural killer cell lymphoproliferative disease

EB病毒(EBV)常使淋巴细胞和上皮细胞两者受染,并诱导具复制性的和潜伏的(持续的)感染,导致多种疾病。淋巴细胞潜伏EBV感染引发异质性淋巴增殖性疾病(LPD),如B细胞LPD和T/NK细胞LPD。源于T细胞和NK细胞的LPD有时有重迭的临床症状和组织学和免疫学特征,因为两种类型的细胞来源于共同的前体细胞。但细胞系的测定在淋巴系新生物分类中是重要的,在大多数场合联合现代技术可从T细胞LPD中区分出NK细胞LPD。因为NK细胞LPD其临床特征、预后和诊断存在异质性,有单或多克隆性(或寡克隆性),本文阐明有关EBV-NK-LPD最近的研究和临床发现,以建立诊断和治疗策略。

Epstein -Barr virus （EBV） exhibited tropism for both lymphocytes and epithelial cells and could induce both replicative and latent （persistent） infections that resulted in a variety of human diseases. With regard to lymphocytes, latent EBV infections was linked to development of heterogeneous lymphoproliferative disease （LPD）, such as B -cell LPD and T- cell/natural killer cell （T/NK cell） LPD. Unlike B -cell LPD,LPD derived from T -cells and NK cells sometimes had overlapping clinical symptoms, as well as histologic and immunophenotypic features, because both types of cells were derived from a common precursor. However, determination of cell lineage was important in classification of lymphoid neoplasms, and combined techniques allowed us to distinguish NK cell LPD from T - cell LPD in most instances. Because NK cell LPD seemed to be heterogeneous in terms of clinical features,prognosis and had a monoclonal or polyclonal （or oligoclonal） nature, this review attempts to clarify recent research and clinical findings and to establish diagnostic and therapeutic strategies.