老年性EBV阳性弥漫性大B细胞淋巴瘤临床病理特征  

Clinicopathologic characteristics of EBV-positive diffuse large B-cell lymphoma in elderly

作　　者：陈少红[1] 叶子茵[2] 杨静[1] 伍丽琼[1] 王小拍[1] 叶瑶[1] 杜洪[1] 

机构地区：[1]广州市第一人民医院病理科,广州510180 [2]中山大学附属第一医院病理科,广州510080

出　　处：《诊断病理学杂志》2015年第11期661-664,668,共5页Chinese Journal of Diagnostic Pathology

基　　金：广州市医药卫生科技项目(20141A011013)

摘　　要：目的探讨老年性EBV阳性弥漫性大B细胞淋巴瘤（EBV＋DLBCL）临床病理特征。方法回顾2010-01—2014-07间所收集DLBCL病例的临床及病理资料,并辅以免疫组化及原位杂交分析。结果共收集154例DLBCL,125例具有完整的临床病理资料;组织学显示大部分为中心母细胞样;原位杂交显示13例DLBCL表达EBV（10.4%）;Cox回归分析显示,EBV感染与患者年龄（≥60）、B症状（有）、结外累及的部位（≥2）、Ann Arbor分级（Ⅲ＋Ⅳ）、IPI评分（2~5）显著相关（P〈0.05）;且患者5年总体生存率与BEV的感染有显著关系（P=0.000）。结论 EBV的感染与DLBCL患者年龄、B症状、结外累及的部位、分级、IPI评分密切相关,EBV＋DLBCL患者与EBV-DLBCL患者相比具有更差的预后。Objective To investigate the clinicopathologic characteristics of EBV-positive diffuse large B-cell lymphoma of the elderly（ EBV ＋ DLBCL）. Methods The clinical and pathological data of DLBCL cases were retrospectively analyzed from January 2010 to July 2014,combined with immunohistochemistry and in situ hybridization（ ISH）.Results A total of 154 DLBCL cases were collected,125 of which were analyzed with a complete set of clinical information; and hematoxylin-eosin examination showed most cases were characterized by a centroblastic population of neoplastic cells. ISH analysis showed that 13 cases expressed EBV（ 10. 4%）; Cox regress showed that EBER positivity was significantly associated with age（ ≥60 years）,the presence of B symptom,more than one extranodal involvement,more advanced stage,higher international prognostic index（ IPI）（ P = 0. 003,0. 024,0. 008,0. 001,0. 027,respectively）;there were significant difference in 5-year overall survival rate between the EBER ＋ and EBER- groups（ P = 0. 000）.Conclusion EBER positivity is significantly associated with age,B symptom,the sites of extranodal involvement,stage and IPI in DLBCL patients. EBER positive patients with DLBCL demonstrate substantially poorer 5-year overall survival rate than EBER negative ones.

关 键 词：老年性 弥漫性大B细胞淋巴瘤 EBV 临床病理特征 

分 类 号：R733.4[医药卫生—肿瘤]