鼻腔鼻窦非霍奇金淋巴瘤免疫表型及其与EB病毒感染的关系

背景与目的:鼻腔鼻窦非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)的患病率和免疫表型组成具有地域性差异.本研究探讨中国广州地区57例鼻腔鼻窦NHL免疫表型及其与EB病毒(Epstein-Barr virus,EBV)感染的关系.方法:收集2000年4月1日至2006年10月31日中山大学肿瘤防治中心病理科57例鼻腔鼻窦NHL标本.免疫组化染色确定免疫表型,EBER原位杂交及PCR检测EBV感染情况.结果:在同期诊断的1 412例NHL中,71例(5.03%)发生于鼻腔鼻窦,其中仅有57例适用于本研究.57例鼻腔鼻窦NHL患者中,男性38例,女性19例,年龄3～75岁,中位年龄50岁;44例(77.19%)为鼻型NK/T细胞淋巴瘤,其中37例(84.09%)为EBV /CD56 NK细胞肿瘤,7例(15.91%)为EBV /CD56-细胞毒性T细胞表型;11例(19.30%)为B细胞淋巴瘤,其中6例为弥漫大B表型,2例为Burkitt(Burkitt样)淋巴瘤(EBV ),1例为髓外浆细胞瘤(EBV ),1例为MALT淋巴瘤(EBV-),1例为小淋巴细胞性淋巴瘤(EBV-);2例(3.51%)为外周T细胞淋巴瘤(EBV-).37例适用DNA检测的病例中,25例(67.57%)感染缺失型LMP1(del-LMP1)EBV株,12例(32.43%)感染野生型LMP1(wt-LMP1)EBV株.结论:鼻腔鼻窦NHL最常见的类型为鼻型NK/T细胞淋巴瘤,可进一步分为EBV /CD56 NK细胞及EBV /CD56-细胞毒性T细胞表型.NK/T细胞淋巴瘤均感染了EBV,EBV株主要为del-LMP1型.

Correlation of immunophenotype of sinonasal non-Hodgkin's lymphoma to Epstein-Barr virus infection

BACKGROUND & OBJECTIVE: There are differences in the prevalence rate and composition of immunophenotypes of sinonasal non-Hodgkin's lymphoma (NHL) depending on the geography. This study was to investigate the immunophenotypes of sinonasal NHLs and their relationship to Epstein-Barr virus (EBV) infection in Guangzhou, China. METHODS: Fifty-seven NHL samples of the sinonasal region were collected from the Department of Pathology, Cancer Center of Sun Yat-sen University from Apr. 1, 2000 to Oct. 31, 2006. HE staining and immunohistochemical staining were performed. Both Epstein-Barr virus-encoded small RNA (EBER) hybridization and PCR were applied to identify EBV infection. RESULTS: Seventy-one sinonasal NHLs were found in all 1 412 NHLs (71/1 412, 5.03%). Only 57 out of the 71 NHL biopsy tissues were suitable for this study. The median age of the patients was 50 years (ranged from 3 to 75 years). There were 38 males and 19 females. Forty-four sinonasal NHLs (44/57, 77.19%) were NK/T-cell lymphoma, nasal type, all of which were infected with EBV. Among them, 37 patients (84.09%) appeared to be NK-cell neoplasm (EBV+/CD56+), and 7 cases (15.91%) showed an EBV+/CD56-cytotoxic T-cell phenotype. Eleven cases (11/57, 19.30%) were B-cell lymphoma. There were 6 cases of diffuse large B-cell immunophenotype, 2 cases of Burkitt (Burkitt-like) lymphoma (EBV+), 1 case of extramedullary plasmacytoma (EBV+), 1 case of MALT-lymphoma (EBV-), and 1 case of small lymphocytic lymphoma (EBV-). Only 2 cases (2/57, 3.51%; EBV-) were peripheral T-cell lymphoma, unspecified. The del-LMP1 EBV strain harbored in 25 out of 37 available DNA samples of NK/T-cell lymphoma (25/37, 67.57%); and the wt-LMP1 EBV strain was found in 12 samples (12/37, 32.43%). CONCLUSION: The most common sinonasal NHL is the NK/T-cell lymphoma, nasal type, which can be further subclassified into NK-cell neoplasm (EBV+/CD56+) and EBV+/CD56-cytotoxic T-cell phenotype. The major EBV strain in NK/T-cell lymphomas is del-LMP1 strain.