鼻NK/T细胞淋巴瘤——15年研究报道

Nasal NK/T-cell lymphoma:a report for 15 years study

目的 :探讨鼻NK/T细胞淋巴瘤 (原诊断为“中线恶性网织细胞增生症”)的临床病理及免疫表型特征、病变性质及其与EB病毒感染的关系。方法 :过去 15年中对近 2 0 0例“中线恶网”病例做了一系列研究 ,包括临床病理分析、LSAB法免疫组化染色作免疫表型分析、用PCR技术作T细胞受体β和γ链基因重排及EBV DNA检测、EBER原位杂交和原位末端标记DNA片段技术检测细胞凋亡。结果 :①鼻NK/T细胞淋巴瘤有特征性临床及病理形态学表现 ;②瘤细胞表达CD3ε:89 8% ;CD45RO :81 2 % ;CD5 6 :81 2 % ;TIA 1:10 0 %。不表达B淋巴细胞和组织细胞分化抗原 ;③TCR β链基因重排检出率为85 7% ,TCR γ链基因重排检出率为 94 45 % ;④EBV DNA检出率为 6 7 86 % ;EBER原位杂交阳性率为 90 6 3% ;⑤肿瘤组织中的凋亡细胞与Ki 6 7+呈明显正相关 (P <0 0 0 6 3) ,Ki 6 7+细胞数量变化与患者的平均生存期有明显关系 (P <0 0 2 )。结论 :“中线恶网”实为EB病毒相关、细胞毒性NK/T细胞淋巴瘤。

Purpose To investigate nasal NK/T cell lymphoma for its features of clinicopathology and immunophenotypes, the nature of the tumor and the relationships between NK/T cell lymphoma and infection of Epstein Barr virus. Method Clinicopathologic study, immunohistochemical staining by LSAB method, TCR β and TCR γ gene rearrangement analysis and detection of EBV DNA by PCR technique, EBER in situ hybridization(ISH) and detection of cell apoptosis by in situ end labeling of fragmented DNA technique were used. Result ① Special clinical presentations and pathologic changes are presented in NK/T cell lymphoma, ②The positivity rates of CD3ε, CD45RO, CD56 and TIA 1 were 89 8%, 81 2%, 81 2% and 100%, respectively. Tumor cells didnt express antigens of B and histiocyte, ③For TCR gene rearrangement analysis,the positivity rates of TCR β and TCR γ chain gene rearrangement were 85 7% and 94 45%, respectively; ④The positivity rate for EBV DNA was 67 86%; and for EBER in situ hybridization,90 63%;⑤ The number of apoptotic cells was correlated to the number of Ki 67+ cells(P<0 0063), and the later one showed a significant impact on the mean survival period of the patients. Conclusion MMR is in deed, a EBV associated cytotoxic NK/T cell lymphoma.