STAT3和STAT5与Survivin和Ki67蛋白在鼻NK/T细胞淋巴瘤中的表达及意义

目的:研究STAT3和STAT5与Survivin和Ki67蛋白在EB病毒(EBV)相关鼻NK/T细胞淋巴瘤中的表达。方法:用免疫组织化学方法检测25例鼻NK/T细胞淋巴瘤患者病理标本STAT3、STAT5和Sur-vivin、Ki67的表达,并对它们的表达作相关性分析。另取20例慢性鼻窦炎患者的鼻腔黏膜作对照。结果:STAT3在鼻NK/T细胞淋巴瘤和慢性鼻窦炎中的阳性率分别为56%和10%;STAT5阳性率分别为68%和15%,均差异有统计学意义(均P<0.01)。Survivin在鼻NK/T细胞淋巴瘤和慢性鼻窦炎中的表达分别为68%和0;Ki67的表达分别为72%和20%,均差异有统计学意义(均P<0.01)。相关性分析发现STAT3的表达与Survivin和Ki67的表达均成正相关(r=0.428,P<0.05和r=0.704,P<0.01);STAT5的表达与Survivin和Ki67的表达无明显相关。结论:STAT通路可能在鼻NK/T细胞淋巴瘤的发生发展中起重要作用,STAT3可能通过诱导Survivin和Ki67的表达参与鼻NK/T细胞淋巴瘤的形成。     

细胞毒蛋白在鼻NK/T细胞淋巴瘤中的表达

目的探讨细胞毒蛋白:T细胞内抗原(TIAI)和丝氨酸蛋白酶-粒酶B(GranzymeB)在鼻NK/T细胞淋巴瘤中的表达及临床意义。方法对17例鼻NK/T细胞淋巴瘤患者临床资料进行分析,并对其组织标本进行免疫组化染色分析。10例B细胞淋巴瘤作为对照。结果鼻NK/T细胞淋巴瘤中TIAI阳性率94.1%(16/17);GranzymeB阳性率为76.5%(13/17)。背景反应性中性粒细胞和组织细胞常TIAI表达阳性,GranzymeB表达阴性。10例B细胞淋巴瘤中TIAI和GranzymeB均表达阴性。随访期(22个月￣66个月)内17例鼻NK/T细胞淋巴瘤8例死亡,9例存活。10例B细胞淋巴瘤中,1例死亡,9例存活。结论再次证实TIAI和GranzymeB对鼻NK/T细胞淋巴瘤的诊断具有较好的敏感性和特异性,对判断该病预后有一定参考价值。     

原发性鼻腔非霍奇金淋巴瘤的免疫表型及其与EB病毒的关系

目的:探讨原发性鼻腔非霍奇金淋巴瘤(NHL)的免疫表型特征及其与EB病毒(EBV)感染的关系。方法:采用免疫组织化学方法检测29例鼻腔NHLCD45RO、CD3ε、CD56、CD20、TIA-1、GranzymeB,确定肿瘤细胞免疫表型以及EBV潜伏膜蛋白(LMP-1);采用原位杂交技术检测EBV编码的RNA(EBER1/2)。结果:CD45RO阳性29例(100.00%),CD3ε、TIA-1及GranzymeB阳性19例(65.52%),CD56阳性17例(58.62%),CD20均阴性;EBER1/2阳性23例(79.31%),LMP-1阳性14例(48.28%)。EBER1/2和LMP-1表达阳性率在外周T细胞淋巴瘤和NK/T细胞淋巴瘤中的差异均无统计学意义(均P>0.05)。结论:鼻腔NHL以NK/T细胞淋巴瘤为多见,EBV感染与鼻腔NHL关系密切,但EBV感染率与鼻腔NHL免疫表型无关,EBV感染在鼻腔NHL的发生、发展中可能起重要作用。     

112例鼻腔NK/T细胞淋巴瘤的预后分析

目的　回顾分析影响鼻腔NK/T细胞淋巴瘤预后的因素。方法　搜集2010~2017年收治的鼻腔NK/T细胞淋巴瘤患者112例,采用Kaplan-Meier法进行单因素生存分析并进行Cox多因素分析。结果　全组5年样本数24例,1年、3年、5年生存率分别为92%、72%、54%。单因素分析显示年龄、性别、白蛋白水平、Ki-67阳性率、治疗模式（放疗、化疗、放化疗联合）、首发症状至确诊时间、首次治疗完全缓解与鼻腔NK/T细胞淋巴瘤的预后相关。多因素分析显示症状首次出现时间至确诊时间及Ki-67阳性率大于50%为影响鼻腔NK/T淋巴瘤预后的独立危险因素。结论　症状首次出现时间至确诊时间及Ki-67阳性率可作为评价鼻腔NK/T淋巴瘤预后的参考因素。     

一般问题

20030483一氧化氮与耳鼻咽喉科肿瘤关系的研究进展(综述)/杜晓东…//临床耳鼻咽喉科杂志一2002,16(10)一573一57520030484四川地区140例上呼吸道NK/T细胞淋巴瘤随访观察/唐琼兰…//中华耳鼻咽喉科杂志一2002,37(5)一393一394 对19年中确诊为上呼吸道NK/T细胞淋巴瘤的140例患者进行了随访,其中存活64例,死亡52例。存活1年以上79例,3年以上61例,5年以上59例。寿命表法统计总的1、3和5年生存率分别为71.8%、55.4%和54.1%。结果表明上呼吸道NK/T细胞淋巴瘤的预后与临床分期、复发、治疗情况及有无全身症状等因素相关,有复发者预后较差,可能…     

鼻及鼻型结外血管中心性T/NK细胞淋巴瘤—定义、鉴别诊断和流行病学

由香港大学主办、多位学者参与的关于鼻及其它结外血管中心性淋巴瘤现状研讨会一致认为 ,与EB病毒高度相关的鼻 T/ NK(T淋巴细胞 /自然杀伤 )细胞淋巴瘤可以作为独立临床病理学名称。EB病毒原位杂交检测对该病早期诊断非常有意义。病变细胞可以是小细胞、中等大细胞或大异型细胞 ,几乎均表现出坏死 ,大多数病例有肿瘤细胞血管浸润。鼻 T/ NK细胞淋巴瘤具有特异性免疫表型 :CD2 阳性、CD56阳性、而大部分表面 CD3阴性 ,但可以在石蜡切片上检出细胞浆 CD3 ,未发现克隆性 T细胞受体基因重排。某些结外淋巴瘤如皮肤、皮下组织和胃肠道淋巴瘤具有与鼻 T/ NK细胞淋巴瘤完全相同的免疫表型和基因型 ,归类为鼻型 T/ NK细胞淋巴瘤。鉴别诊断包括淋巴瘤样多发性肉芽肿、母细胞或单一形态性 NK细胞淋巴瘤 /白血病、CD56阳性的周围 T细胞淋巴瘤和肠病相关性 T细胞淋巴瘤     

以眼部症状为突出表现的鼻NK/T细胞淋巴瘤

目的:探讨以眼部症状为突出表现的鼻NK/T细胞淋巴瘤的临床特点及误诊原因。方法:回顾性分析2009-2011年诊治的11例以眼部症状为突出表现的鼻NK/T细胞淋巴瘤患者的临床资料。结果:首诊误诊率为72.7%,1次病理检查误诊率为27.3%。以眼部症状为突出表现的鼻NK/T细胞淋巴瘤发病较快,影像学表现相对特异。结论:以眼部症状为突出表现的鼻NK/T细胞淋巴瘤易误诊;结合临床特点、影像学表现,经病理学检查有助于尽早确诊。     

EB病毒潜伏膜蛋白1和鼻咽癌上皮间质转化相关分子与颈淋巴结转移关系

目的:评价EB病毒潜伏膜蛋白1(LMP-1)和鼻咽癌上皮间质转化相关分子与颈淋巴结转移关系.方法:88例鼻咽癌活检标本依据病理检查或MRI检查分成病理转移组(18例)、MRI转移组(40例)和无转移组(30例).免疫组织化学检测鼻咽癌组织中潜伏膜蛋白1(LMP-1)、STAT3、Twist、E-cadherin和Vimentin的表达情况.结果:88例鼻咽癌组织中,LMP-1阳性表达见于35例,阳性率为38.7%.病理转移组、MRI转移组和无转移组的LMP-1阳性率分别为38.9%(7/18)、47.5%(19/40)和30.0%(9/30),3组间差异无统计学意义.LMP-1表达分别与Twist和Vimentin表达呈正相关(r=0.276和0.282,均P<0.01),与STAT3和E-Cadherin表达无相关性.88例鼻咽癌组织中STAT3、Twist和Vimentin阳性率以及E-Cadherin异常表达率分别64.8%(57/88)、54.5%(48/88)、20.0%(22/88)和60.2%(53/88).STAT3、Twist和Vimentin阳性率以及E-Cadherin异常表达率在病理转移组、MRI转移组和无转移组间差异均分别有统计学意义(均P<0.05).STAT3表达分别与Twist和Vimentin表达均呈正相关性(r=0.712和0.316,均P<0.01).结论:EMT在鼻咽癌转移过程中起着重要作用.LMP-1可能仅作为上游影响因素之一间接影响EMT的发生,但与颈部淋巴结转移可能无直接相关性.     

鼻腔鼻窦淋巴瘤早期诊断和治疗

鼻腔鼻窦淋巴瘤依免疫组化分型分为B细胞、T细胞和NK/T细胞淋巴瘤。众所周知鼻腔鼻窦淋巴瘤具有明显的地域分布特征[1],西方白种人多见B细胞淋巴瘤,而亚洲和南美洲人多见T细胞和NK/T细胞淋巴瘤,且以NK/T细胞淋巴瘤居多。鼻型NK/T细胞淋巴瘤约占亚洲和南美洲所有非霍奇金淋     

STAT6在鼻息肉组织中的表达及其与嗜酸粒细胞浸润的关系

目的：研究信号转导和转录激活因子6（STAT6）在鼻息肉组织中的表达及其对嗜酸粒细胞（EOS）浸润聚集的作用,探讨其在鼻息肉发生中的可能作用。方法：选取符合纳入标准的鼻息肉患者手术切除标本（鼻息肉组）30例和同期单纯行鼻中隔偏曲矫正术中切除的下鼻甲组织（对照组）10例。采用免疫组织化学SP法检测2组下鼻甲黏膜中STAT6的表达。应用SPSS13.0软件进行统计学分析。结果：STAT6和EOS在鼻息肉组织中的表达明显高于下鼻甲,差异有统计学意义（P〈0.05）。STAT6阳性细胞主要集中于鼻息肉的上皮细胞、腺体细胞和组织中浸润的炎性细胞的细胞质中。鼻息肉组中STAT6的表达与EOS浸润程度一致（P〈0.01）。结论：STAT6在鼻息肉组织中的高表达及其对EOS浸润聚集的作用,可能与鼻息肉的发生和发展关系密切。     

Detection of Epstein-Barr virus and subsets of lymphoid cells in adenoid tissue of children under 2 years of age

Epstein-Barr virus (EBV) has been closely associated with undifferentiated nasopharyngeal carcinoma (NPC) and T/NK nasal non Hodgkin lymphoma. Nevertheless, the presence of EBV in non neoplastic lymphoid tissue of the nasopharynx has been rarely investigated. In a previous study by our group, using in situ hybridization to detect EBV in adenoids of children (2-13 years old) resected because of nasal obstruction due to hypertrophy, we found EBV genome in 72% of the cases. It was now intended to study the frequency of EBV expression in adenoids from children that underwent surgical removal, belonging to a lower age group (1-2 years old). It was also intended to establish which lymphoid subsets are involved in this infection. Adenoidal paraffin sections from 21 patients aged 1-2 years old (mean 1.6 years), 15 males and six females were submitted to double labeling: in situ hybridization with EBER 1/2 probes to detect EBV and immunohistochemistry to determine the lymphocyte typing of EBV-positive cells (CD20 for B-lymphocytes, CD3 for T-lymphocytes and CD56 and CD57 for NK-cells). Among 21 patients, seven showed positive lymphoid cells for EBV (33%). In almost all cases, EBV-positive cells were also CD20-positive. Some EBV-positive cells showed no labeling with any of the lymphoid markers, but in no instance they were positive for CD3, CD56 or CD57. This study confirms the preferential infection of B-lymphocytes by EBV, which in some instances can down regulate the expression of CD20.     

57例鼻腔鼻窦T细胞淋巴瘤临床疗效及预后分析

目的探讨鼻腔鼻窦T细胞淋巴瘤临床疗效及预后因素。方法回顾性分析1983年7月~2001年4月我院收治的57例鼻腔鼻窦T细胞淋巴瘤,其中单纯放疗(R组)22例,放疗 化疗(R C组)35例。Kaplan-Meier法计算3,5年生存率和局控率,Logrank进行显著性检验和单因素分析,Cox模型进行多因素分析。结果放疗组(R组)和放疗 化疗组(R C组)3,5年生存率分别为64.7%,55.2%和74.4%,69.8%。两组3,5年生存率比较有统计学意义(P<0.05)。两组3,5年局控率分别为95.4%,87.2%和94.5%,89.7%。两组3,5年局控率比较无统计学意义(P>0.05)。多因素分析显示,B症状、临床分期、治疗方式和放疗剂量是影响鼻腔鼻窦T细胞淋巴瘤生存率的独立预后因素;影响鼻腔鼻窦T细胞淋巴瘤局控率的独立预后因素是累及部位、临床分期、治疗方式、放疗剂量。结论放疗 化疗组(R C组)明显提高了鼻腔鼻窦T细胞淋巴瘤3,5年生存率,但不能改善局控率。B症状、临床分期、治疗方式和放疗剂量是影响鼻腔鼻窦T细胞淋巴瘤生存率的重要因素,累及部位、临床分期、治疗方式、放疗剂量与鼻腔鼻窦T细胞淋巴瘤局控有关。     

Clinicopathologic study of non-Hodgkin lymphoma in sinonasal and hard palate regions in 15 Japanese cases

Non-Hodgkin lymphomas of the sinonasal region have been the subject of numerous studies. Previous reports have suggested that nasal lymphomas occurring in Orientals are mostly of the natural killer cell (NK)/T-cell phenotype which contrasts with the preponderance of the B-cell type in western populations. Recent studies indicated that NK/T-cell lymphoma constitutes the clinical condition of lethal midline granuloma. These reports led us to question whether all NK/T lymphomas are always lethal midline granuloma. We have investigated a series of 15 cases of non-Hodgkin lymphomas in the nasal and/or paranasal sinuses clinically, immunohistochemically and for the presence of Epstein-Barr virus (EBV). This study showed that the presence of EBV was common in nasal NK/T lymphoma, and this type of lymphoma was clearly highly frequent in other types of nasal lymphoma in our department. Moreover, in 4 cases of NK/T-cell lymphomas, the clinical features of lethal midline granuloma did not appear, indicating that NK/T lymphomas are not always lethal midline granuloma.     

Lymphoma of the nasal cavity,clinical and anatomo-pathologic considerations

Six cases of high-grade lymphoma affecting the nasal cavity are presented. Their main symptoms were nasal obstruction, epistaxis and rhinorrea. Clinical exploration showed an ulcerated lesion in four patients (all of them T/NK cell lymphomas) and an exofitic tumour in the other two (B cell lymphomas). Pathology was diagnostic for high grade lymphoma in all the six cases, immunohistochemical studies revealed that the atypical cells were T/NK in 4 cases and B in the other two cases. Genotypic analysis was done looking for rearrangement of the genes for Ig H or T-cell receptors. In situ hybridisation was done to detect Epstein-Barr virus RNA. Malignant lymphomas arising in the nasal cavity are unusual, its major prognostic factor is the clinical stage at presentation. To perform an early diagnosis this neoplasia must be suspected in the presence of an exofitic tumour (B cell lymphoma) or necrotic and ulcerated lesion (T/NK cell lymphoma).     

Angiogenic non-Hodgkin T/natural killer (NK)-cell lymphoma: report of three cases

Angiogenic T/natural killer (NK)-cell lymphoma is a non-Hodgkin lymphoma characterized by necrosis and vascular destruction that is strongly associated with Epstein-Barr virus and AIDS. Early diagnosis is essential to improve the chances of patient survival, but severe local inflammatory infiltrate impairs histologic diagnosis by obscuring neoplastic cells. The most common markers are CD2, CD56, cytoplasmic CD3, and CD43 EBV. We describe 3 cases of angiogenic T/NK-cell lymphoma that show the diverse presentation of the same disease. Patient 1 was HIV positive and had nasal obstruction, facial edema, and ulceration of the nasal mucosa. Patient 2 had fever, a sore throat, and weight loss. Patient 3 had facial edema, fever, proptosis, and rapid development of neurologic alterations. Several biopsies were needed for histologic confirmation in these patients, despite positivity for the CD3 and CD56 markers.