血清VCA-IgA EA-IgA Rta-IgG水平与鼻咽癌病理分期相关性及联合监测的临床意义

目的 探讨EB病毒壳抗原免疫球蛋白A、EB病毒早期抗原免疫球蛋白A、Rta蛋白抗体与鼻咽癌病理分期的相关性及联合监测的临床意义.方法 将84例鼻咽癌患者设为鼻咽癌组,同期防癌查体合格且无鼻炎病史的EB病毒壳抗原免疫球蛋白A阳性者52名设为对照1组,健康体检者48名设为对照2组.比较3组血清EB病毒壳抗原免疫球蛋白A、E...     

EB病毒抗体及其DNA联合检测在鼻咽癌筛查和早期诊断中的价值

目的探讨EB病毒(EBV)抗体及EBV DNA联合检测在鼻咽癌筛查和早期诊断中的价值。方法收集2011年7月至2014年8月广东省第二人民医院经病理确诊的鼻咽癌患者272例,采用酶联免疫法(ELISA)测定血清RTA-IgG、VCA-IgA和EA-IgA;荧光定量聚合酶链反应(PCR)测定血浆EBV-DNA。结果四项指标联合检测时,其敏感度最高(99.63%);早期鼻咽癌的阳性率为97.62%(41/42),晚期鼻咽癌的阳性率为100.00%(230/230)。四项指标中任意两项及两项以上指标为阳性的特异性在93.00%以上。结论四项指标联合检测可用于早期鼻咽癌的筛查,任意两项以上指标阳性时应高度怀疑鼻咽癌。     

DNA修复基因和EB病毒的交互作用与鼻咽癌易感性初步研究

【目的】探讨在鼻咽癌群体中DNA修复基因与EB病毒的交互作用。【方法】选取广东地区以广东话为主要语言的人群建立匹配的鼻咽癌病例和健康对照（病例/对照=755/755）,收集其临床流行病学资料、采集外周血样并进行EB病毒抗体检测和SNP基因型分型。利用决策森林方法,分析DNA修复通路104个基因中768个SNP位点和EB病毒在鼻咽癌中的交互作用。【结果】MDC1、ATM、GTF2H4、MLH1、RAD51L1、XPC、GTF2H1与EB病毒的交互作用达到Bonferroni多重检验校正的显著性水准（0.05）。P 值分别为7.62×10-5 、8.20×10-5、8.55×10-5、1.60×10-4、1.80×10-4、2.20×10-4、和2.42×10-4;其鼻咽癌患病风险比OR (95%CI)分别为15.97(4.17-61.11)、11.32(7.22-25.45)、15.94(4.17-64.01)、5.38(4.88-6.74)、151.47(53.79-380.39)、40.92(15.09-112.67)和142.38(53.38-377.5)。进一步生物信息学基因网络分析表明,这些基因可能通过影响EB病毒DNA复制过程等多种直接或间接的方式,改变广东人群鼻咽癌的易感性。【结论】EB病毒与修复基因的交互作用可能是鼻咽癌的另一重要的易感性机制。     

The Role of Antiviral Prophylaxis for the Prevention of Epstein–Barr Virus–Associated Posttransplant Lymphoproliferative Disease in Solid Organ Transplant Recipients: A Systematic Review

The role of antiviral prophylaxis for the prevention of posttransplant lymphoproliferative disease (PTLD) remains controversial for solid organ transplantation (SOT) recipients who are seronegative for Epstein–Barr virus (EBV) but who received organs from seropositive donors. We performed a systematic review and meta‐analysis to address this issue. Two independent assessors extracted data from studies after determining patient eligibility and completing quality assessments. Overall, 31 studies were identified and included in the quantitative synthesis. Nine studies were included in the direct comparisons (total 2366 participants), and 22 were included in the indirect analysis. There was no significant difference in the rate of EBV‐associated PTLD in SOT recipients among those who received prophylaxis (acyclovir, valacyclovir, ganciclovir, valganciclovir) compared with those who did not receive prophylaxis (nine studies; risk ratio 0.95, 95% confidence interval 0.58–1.54). No significant differences were noted across all types of organ transplants, age groups, or antiviral use as prophylaxis or preemptive therapy. There was no significant heterogeneity in the effect of antiviral prophylaxis on the incidence of PTLD. In conclusion, the use of antiviral prophylaxis in high‐risk EBV‐naive patients has no effect on the incidence of PTLD in SOT recipients.     

A Spectrum of Basaloid Morphology in a Subset of EBV-Associated “Lymphoepithelial Carcinomas” of Major Salivary Glands

Nasopharyngeal carcinomas of the undifferentiated or lymphoepithelial type are most commonly seen in South East Asians. Identical tumors have also been described at a variety of other sites including lung, skin and salivary gland and have been referred to by a number of names including lymphoepithelial carcinoma (LEC). LECs of major salivary gland are extremely rare. They are particularly common amongst the Inuit populations of the arctic region including Greenland (Denmark), Canada and Alaska, as well as South East Asians. Within the Inuit group, this tumor represents the majority of all salivary gland carcinomas. Amongst primary LEC of major salivary gland, most cases reported in the literature have represented typical nasopharynx-like tumors. Variants of Epstein–Barr Virus (EBV) associated LEC have not been described previously, to the best of our knowledge. In this report, we describe 4 EBV-associated major salivary gland LECs with prominent basaloid morphology, which represent 22 % of a cohort of 18 salivary LECs from an Inuit population in Greenland. The features described in these cases raise a differential diagnosis of other basaloid tumors, particularly in light of the salivary gland location. A basaloid variant of LEC in major salivary gland should be recognized, especially in highly prone populations, to avoid misdiagnosis of other more common salivary tumors.     

抗重组EB病毒抗原双重抗体检测血清学诊断鼻咽癌的研究

背景与目的：在评估4种EB病毒抗原酶联免疫吸附法的基础上,探讨优化抗重组：EB病毒抗原双重抗体检测应用于血清学诊断鼻咽癌。方法：收集广州地区57例治疗前鼻咽癌患者和58例健康成人的血清。应用：EB病毒特异抗原(谷胱甘肽转移酶重组融合蛋白)为基础的4种免疫酶联吸附法,即：EBNA1-IgA,EBNA1-Igg,Zta-IgA和Zta-IgG检测血清中抗EB病毒的抗体水平。结果：EBNA1-IgA的灵敏度(O．9123)和阴性预测值(0．9074)是单独使用4种ELISA实验中最高的。Zta-IgA具有最高的正确率(π,0．8870)和Youden指数(J,0．7738)。当评估配对的ELISA时,EBNA1-IgA和Zta-IgA双重阳性的所有指标是4种双重阳性实验中最高的。5例：EBNA1-IgA阴性的鼻咽癌患者呈Zta-IgA阳性,而7例Zta-IgA阴性的鼻咽癌患者呈EBNA1-IgA阳性。结论：EBNA1-IgA酶联免疫吸附的单独检测在血清学诊断鼻咽癌时优于其他3项(EBNA1-IgG、Zta-IgA和Zta-IgG)单独酶联免疫吸附检测。EBNA1-IgA和Zta-IgA两项的组合应用在血清学诊断鼻咽癌时有互补作用,是血清学检测的合适组合。     

EB病毒在原发性扁桃体弥漫大B细胞淋巴瘤（PTDLBCL）中的表达及其临床意义

 目的  探讨EB病毒(Epstein-Barr virus,EBV)在原发性扁桃体弥漫大B细胞淋巴瘤(primary tonsillar diffuse large B cell lymphoma,PTDLBCL)内的感染情况及其临床病理学意义。方法  采用EBV编码微小RNA(EBV encoded miRNA,EBERs)原位杂交(in situ hybridization,ISH)和EBV潜伏膜蛋白1 (latent membrane protein 1,LMP1),PCR检测EBV在PTDLBCL (n=81)和原发性非扁桃体弥漫大B细胞淋巴瘤(primary non tonsillar diffuse large B cell lymphoma,PNTDLBCL) (n=42)、鼻腔NK/T细胞淋巴瘤(n=10)及慢性扁桃体炎(n=20)中的感染情况,并分析差异。结果  ISH结果显示,PTDLBCL中EBV的阳性率高于PNTDLBCL (t=5.603,P=0.018)。检测PTDLBCL中EBV,PCR阳性率显著高于ISH (t=11.139,P=0.001)。EBV阳性PTDLBCL者预后优于阴性者 (t=5.683,P=0.017);与患者年龄、部位及性别的差异无统计学意义。结论  EBV在PTDLBCL中高表达,其存在与患者预后正相关。检测PTDLBCL的EBV,LMP1 PCR的敏感度高于EBERs ISH,而EBERs ISH的特异度高于LMP1 PCR。     

Analysis of Killer Cell Activities in Epstein-Barr Virus Infections

Using spontaneously established autologous lymphoblastoid B cell lines (LCL), killer cell activities were studied in children with severe infectious mononucleosis (IM), chronic IM, and acute IM, and compared with those in EBV-seropositive normal controls. Natural killer (NK) cell activity of fresh peripheral blood mononuclear cells (PBMC) was normal in acute IM patients, but it was low in four of six patients with severe or chronic IM. Recombinant inter-leukin 2 (rIL-2)-activated PBMC from normal controls showed lymphokine-activated killer (LAK) cell activity against the respective autologous LCL. The levels of LCL lysis by LAK cells were significantly higher in acute IM patients, lower in chronic IM patients, and much lower in severe IM patients. In contrast to the fact that PBMC stimulated in vitro with autologous LCL (IVS cells) from normal controls and acute IM patients showed potent killing of autologous LCL, IVS cells from severe or chronic IM patients showed lower levels of LCL lysis, which were markedly augmented in three patients by rIL-2 addition to the cultures. These killer cell dysfunctions appear to be responsible for the severe or chronic course of EBV infection.