非特指性外周T细胞淋巴瘤中EBER、LMP1的表达及与预后的关系

Correlation of the expression of EBER and LMP1 with prognosis in peripheral T-cell lymphoma,not otherwise specified

目的 探讨非特指性外周T细胞淋巴瘤（peripheral T-cell lymphoma,not otherwise specified,PTCL-NOS）中EBER、LMP1的表达及与患者预后的关系。方法 采用原位分子杂交（in situ hybridization,ISH）技术和免疫组化法分别检测81例PTCL-NOS及59例对照组[48例血管免疫母细胞性T细胞淋巴瘤（angioimmunoblastic T-cell lymphoma,AITL）和11例结外NK/T细胞淋巴瘤（extranodal NK/T cell lymphoma,ENK/TCL）]中EBER和LMP1的表达,并分析EBER表达与PTCL-NOS患者临床病理特征及预后的关系。结果 （1）81例PTCL-NOS中,EBER阳性率为43.2%（35/81）;35例EBER阳性的PTCL-NOS病例中免疫组化得分1分＋2分者共29例,占EBER阳性病例的82.9%（29/35）,3分＋4分者共6例,占17.1%（6/35）。EBER表达与PTCL-NOS患者年龄、性别、乳酸脱氢酶（lactate dehydrogenase,LDH）水平及临床分期均无明显相关性（P〉0.05）。（2）81例PTCL-NOS组织中,LMP1蛋白阳性率为22.2%（18/81）。LMP1蛋白表达与EBER表达具有一致性,但EBER阳性率明显高于LMP1（P〈0.05）。（3）33例PTCL-NOS获得临床随访资料,随访时间1～63个月,中位生存期为23个月,总生存率为33.3%（11/33）。Kaplan-Meier生存曲线分析显示,EBER阳性组的生存率明显低于EBER阴性组（P〈0.05）。结论 EB病毒（EBV）感染可能是PTCL-NOS发生、发展中重要但非根本性的因素。EBER-ISH检测EBV感染具有较高的敏感性和特异性。EBV感染对PTCL-NOS患者的预后判断具有重要意义。

Purpose To investigate the expression of EBER and LMP1 in peripheral T-cell lymphoma, not otherwise specified （ PTCL- NOS） and their relation to the prognosis. Methods In situ hybridization analysis for the expression of EBER and immunohistochemical analysis for LMP1 were performed in 81 cases of PTCL-NOS and 59 cases of controls. The relationship between EBER expression, and elinicopathologic features and prognosis was also analyzed. Results The positive rate of EBER was 43.2% （35/81） in 81 PTCL- NOS. Twenty-nine of 35 （82.9%） EBER-positive cases were scored as 1 and 2, 6 of 35 （ 17.1% ） , as 3 and 4. EBER expression showed no significant correlation with age, sex, LDH level and clinical stage （ P 〉 0. 05 ）. The expression rate of LMP1 protein was 22. 2% （18/81） in 81 PTCL-NOS. LMP1 protein expression was consistent with that of EBER, but the positive rate of EBER expression was significantly higher than that of LMP1 protein in PTCL-NOS. Follow-up data was available in 33 cases with a range of 1 to 63 months. The overall survival rate was 33.3% （11/33） with median survival time of 23 months. Kaplan-Meier survival curve showed survival rate of EBER-positive group was significantly lower than that of EBER-negative group （ P 〈 0.05 ）. Conclusions EB virus （EBV） may be an important but non fundamental factor in the tumorigenesis of PTCL-NOS. In situ hybridization analysis of EBER expression has high sensitivity and specificity for detection of EBV infection. EBV-positivity has great importance to evaluate the prognosis of PTCL-NOS patients.