结外NK/T细胞淋巴瘤检测EB病毒与疗效关系的研究*

目的：探讨血浆中EB病毒阳性在评价结外NK/T细胞淋巴瘤近期疗效和远期疗效中的临床意义。方法：收集2011年1 月至2014年4 月郑州大学第一附属医院经病理及免疫组化确诊为结外NK/T细胞淋巴瘤的患者109 例，应用qRT-PCR方法检测其血浆中EBV-DNA拷贝数，比较EBV 阴性和EBV 阳性患者对治疗疗效与预后的差异。结果：109 例结外NK/T细胞淋巴瘤患者，53例阳性患者中有34例（64.2%）为晚期（Ⅲ～Ⅳ期），56例阴性患者中22例（39.3%）为晚期（Ⅲ～Ⅳ期），EBV 阳性组中伴有B 症状
33例（62.3%），阴性组患者21例（37.5%），EBV 阴性患者与EBV 阳性患者在分期及B 症状方面均具有统计学意义（P<0.05）。 34例（60.7%）EBV 阴性结外NK/T细胞淋巴瘤患者达到客观缓解率，显著高于EBV 阳性患者的客观缓解率（22例，41.5%）（P<0.05）。EBV 阴性组与EBV 阳性组相比，其2 年无进展生存期更高（P<0.05）。 结论：检测结外NK/T细胞淋巴瘤患者血浆中EB病毒对评价其近期疗效及2 年无进展生存期具有重要的临床意义。

Detecting EB virus to determine curative effect in extranodal natu-ral killer/T-cell lymphoma

Objective:To investigate the clinical significance of detecting Epstein Barr virus (EBV) infection in evaluating recent curative and long-term effects in patients with extranodal natural killer (NK)/T-cell lymphoma. Methods:The EBV-DNA copies in the plasma of 109 patients, who were pathologically and immunohistochemically diagnosed with extranodal natural killer/T-cell lymphoma in the First Affiliated Hospital of Zhengzhou University between January 2011 and April 2014, were monitored via quantitative re -al-time polymerase chain reaction. Subsequently, the difference in recent curative and long-term effects between EBV positive and EBV negative patients was compared.Results:Among the 109 patients with extranodal NK/T-cell lymphoma, 34(64.2%) cases of EBV posi-tive patients were at the advanced stage (Ⅲ～Ⅳstages), and 22(39.3% ) cases of EBV negative patients were at the terminal stage ( Ⅲ～Ⅳstages). EBV positive patients who accompanied by B symptoms were 33(62.3%) , and there were21(37.5%) cases with B symptoms in EBV negative patients, the differences between stages and B symptoms were statistically significant. The attained objec -tive response rate of the EBV-DNA negative patients (34, 60.7%) was significantly higher than that of the EBV-DNA positive patients (22, 41.5%) (P<0.05). Similarly, the 2-year progression-free survival (PFS) rate of EBV negative patients was better than that of EBV positive patients (P<0.05). Conclusion:Detecting EBV in plasma has clinical significance in evaluating the recent curative effect and the 2-year PFS rate in patients diagnosed with extranodal NK/T-cell lymphoma.