初治霍奇金淋巴瘤中EB病毒感染状态与预后分析  

Infection status and prognostic significance analysis of Epstein-Barr virus in 207 cases with newly diagnosed Hodgkin＇s lymphoma

作　　者：康愫意[1] 秦燕[1] 何小慧[1] 周生余[1] 韩晓红[1] 刘鹏[1] 董梅[1] 周立强[1] 杨建良[1] 杨晟[1] 张长弓[1] 桂琳[1] 石远凯[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院内科 抗肿瘤分子靶向药物临床研究北京市重点实验室,100021

出　　处：《中华医学杂志》2015年第32期2594-2598,共5页National Medical Journal of China

基　　金：国家科技支撑计划（2014BA109812）

摘　　要：目的 评估霍奇金淋巴瘤患者EB病毒（EBV）感染状态及EBV阳性对患者治疗及预后的影响.方法 选取2008年2月至2014年10月中国医学科学院肿瘤医院收治的207例初治霍奇金淋巴瘤患者,统计原位杂交方法检测蜡块中EBV编码的RNA（EBER）或免疫组化方法检测蜡块中潜伏膜蛋白-1（LMP-1）的结果,确定EBV感染状态,分析EBV阳性与临床特征相关性及其对患者预后的影响.结果 207例患者淋巴瘤组织中,共检测出EBV阳性66例,阳性率为31.9％.EBV阳性患者中,男性多见（46/66,69.7％）,病理亚型以混合细胞型为主（34/66,51.5％）.EBV阳性患者呈年龄双峰分布,分别是在年龄0～15岁和年龄＞ 60岁.全组患者中位随访35个月,EBV阳性患者的总生存时间短于EBV阴性患者（P=0.001）,无进展生存时间二者间差异无统计学意义（P =0.763）.结论 EBV阳性是霍奇金淋巴瘤患者总生存时间的不良预后因素.Objective To evaluate the Epstein Barr virus （EBV）positive rate in untreated Hodgkin＇s lymphoma（HL） and investigate the prognostic significance of EBV status.Methods A total of 207 previously untreated patients with histologically confirmed Hodgkin＇s lymphoma were enrolled in the study.The EBV infection status was confirmed through examining EBV-RNA （EBER） or EBV latent membrane protein-1.The correlation of clinical features and EBV infection status was analyzed,also the prognostic significance of EBV infection.Results A total of 66 cases were confirmed to be EBV positive Hodgkin＇s lymphoma（EBV ＋ HL） in all 207 cases,accounting for 31.9%.EBV ＋ HL group had more male patients （46/66,69.7%） and mixed cellularity subtype （34/66,51.5%） than EBV negative Hodgkin＇s lymphoma（EBV-HL） group.The EBV positive rate had two peaks in age,respectively,in the age of 0-15 year-old and 〉 60 year-old.During a median follow-up period of 35 months,EBV-HL was significant better than EBV ＋ HL in overall survival（P =0.001）,but no significant difference was found in progression-free survival（P =0.763）.Conclusion EBV positive is a poor prognostic factor for overall survival time in HL.

关 键 词：爱泼斯坦巴尔病毒感染 淋巴瘤 预后 

分 类 号：R733.1[医药卫生—肿瘤]