EB病毒阳性的胃弥漫大B 细胞淋巴瘤特点及预后

目的:探讨EB病毒阳性患者的胃弥漫大B 细胞淋巴瘤（diffuse large B-celllymphoma，DLBCL ）病理学特点及预后。方法:回顾性分析北京大学基础医学院病理学系2009年1 月至2015年1 月75例胃弥漫大B 细胞淋巴瘤患者的临床资料，15例EB病毒（Epstein-Barr virus，EBV ）阳性者为病例组，60例EBV 阴性者为对照组，采用免疫组织化学法和EB病毒RNA 探针原位杂交法检测Bcl- 2、c-myc 蛋白表达及EBV-EBER 情况，分析EBV 阳性的胃DLBCL 患者的病理学特点及预后。结果:EBV 阳性组在临床表现、年龄、性别、起源、细胞形态等方面与EBV 阴性组相比，差异无统计学意义（P > 0.05）；在Bcl- 2、c-myc 蛋白表达方面，EBV 阳性组与EBV 阴性组相比，差异无统计学意义（P > 0.05）；R-CHOP 方案治疗下，EBV 阳性组与EBV 阴性组相比，中位总生存期（median overallsurvival，OS）分别为15.1 个月和31.4 个月，差异具有统计学意义（P = 0.01）。 结论:发生于胃DLBCL 患者中，EB病毒感染对临床表现、瘤细胞的起源、形态、蛋白表达等方面无明显影响；EB病毒阳性的DLBCL 患者并不局限于老年人；R-CHOP 治疗下EB病毒阳性患者的预后比EB病毒阴性的患者预后差。 

Characteristics and prognosis of EBV-positive gastric diffuse large B-cell lymphoma

Objective:To investigate pathological characteristics and prognosis of patients with Epstein-Barr virus (EBV) positive gastric diffuse large B-cell lymphoma (DLBCL). Methods:Through retrospective study, we collected 75 cases of patients with DLBCL that oc-curs in the stomach. The patients were divided into two groups consisting of 60 cases of EBV negative control group and 15 cases of EBV positive group. To analyze the pathological characteristics and prognosis of patients with EBV positive gastric DLBCL, immunohisto-chemical and Epstein-Barr encoding region (EBER) in situ hybridization methods were used to detect Bcl-2, c-myc protein expression, and EBV-encoded RNA (EBER). Results:In certain aspects of clinical manifestations, such as age, gender, and origin, the comparison be-tween EBV-positive and EBV-negative groups had no statistically significant difference. The same results were obtained for Bcl-2 and c-myc protein expression. However, a statistically significant difference (P=0.01) was observed under the R-CHOP regimen where the me-dian overall survival (OS) of the EBV-positive and EBV-negative groups were 15.1 and 31.4 months, respectively. Conclusion:In pa-tients with DLBCL of the stomach, the EBV infection had no obvious effects in terms of clinical manifestation, origin, morphology, and protein expression of tumor cells. EBV-positive DLBCL was not limited to elderly patients. Under the R-CHOP regimen, the prognosis of EBV-positive patients was worse than that of EBV-negative patients.