EBNA2免疫组化在EB病毒阳性淋巴组织疾病中的表达意义  

Significance of EBNA2 expression in EBV positive lymphoid tissue diseases

作　　者：张燕林[1] 贺文 谢建兰[1] 郑晓丹[1] 郑媛媛[1] 周小鸽[1] ZHANG Yan-lin;HE Wen;XIE Jian-lan;ZHENG Xiao-dan;ZHENG Yuan-yuan;ZHOU Xiao-ge(Department of Pathology,Bejing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Pathology,Tongzhou Maternal and Child Heath Hospital,Beijing 101110,China)

机构地区：[1]首都医科大学附属北京友谊医院病理科,北京100050 [2]通州区妇幼保健院病理科,北京101110

出　　处：《诊断病理学杂志》2024年第4期300-303,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的观察EBNA2免疫组化在不同EB病毒阳性淋巴组织疾病中的表达差异、分析其在病理诊断与鉴别诊断中的价值。方法收集344例EB病毒阳性的淋巴组织疾病,总结EBNA2免疫组化在病变中的表达特点。结果不同的EBV阳性淋巴组织病变,EBNA2的阳性表达不同:IM中阳性39例(39/46),EBV阳性的弥漫大B细胞淋巴瘤3例(3/30),淋巴瘤样肉芽肿1例(1/5),纤维素相关弥漫大B细胞淋巴瘤2例(2/2),浆母细胞淋巴瘤1例(1/14),免疫相关淋巴组织增殖性疾病32例(32/58)(包括移植后淋巴组织增殖性疾病21例,HIV相关Burkitt淋巴瘤1例,HIV相关弥漫大B细胞淋巴瘤2例,原发免疫缺陷疾病相关淋巴组织疾病6例,医源性免疫相关淋巴组织增殖性疾病2例)。其余均显示EBNA2阴性。②不同病变中的EBNA2阳性细胞表达明显不同:传染性单核细胞增多症中的EBNA2阳性细胞相对较少,并且多呈散在分布,几乎很少见到簇状聚集的情况。EBNA2阳性细胞多表现为≤10个/HPF,少见11~50个/HPF,仅有个别病例显示大于50个/HPF。免疫相关淋巴组织增殖性疾病中,出现大量EBNA2阳性细胞,阳性细胞较弥漫分布,大部分为强阳性,并且阳性细胞多显示大于50个/HPF。结论EBNA2阳性在疾病的诊断及鉴别诊断提供了新的依据,具有一定的价值;当病变表达EBNA2时,提示患者可能存在免疫缺陷或处于免疫失调状态,对临床诊断及治疗具有一定的指导意义。Objective To observe the differential expression of EBNA2 immunohistochemistry in different EBV positive lymphoid tissue diseases and to analyze its value in pathological diagnosis and differential diagnosis.Methods A total of 344 cases of EB virus positive lymphoid tissue diseases were collected and the expression characteristics of EBNA2 immunohistochemistry in the lesions were summarized.Results The positive expression of EBNA2 varied among different EBV positive lymphoid tissue lesions:in infectious mononucleosis,39 cases were positive(39/46),3 cases were EBV positive diffuse large B-cell lymphoma(3/30),1 case was lymphomatoid granuloma(1/5),2 cases were fibrin-associated large B-cell lymphoma(2/2),and 1 case was plasmablastic lymphoma(1/14),32 cases of immune related lymphoproliferative diseases(32/58)(including 21 cases of post transplant lymphoproliferative diseases,1 case of HIV related Burkitt lymphoma,2 cases of HIV related diffuse large B-cell lymphoma,6 cases of primary immunodeficiency disease related lymphoproliferative diseases,and 2 cases of iatrogenic immune related lymphoproliferative diseases).The rest showed negative EBNA2.The expression of EBNA2 positive cells varied among different lesions:EBNA2 positive cells in infectious mononucleosis were relatively few and mostly scattered,with almost no cluster like aggregation observed.EBNA2 positive cells were mostly manifested as≤10/HPF,with rare 11-50/HPF,and only a few cases showing more than 50/HPF.In immune related lymphoproliferative diseases,a large number of EBNA2 positive cells were present,with a diffuse distribution of positive cells,most of which were strongly positive,and most of the positive cells showed more than 50/HPF.Conclusion EBNA2 positivity provides a new basis for the diagnosis and differential diagnosis of diseases,and has useful value;When EBNA2 is expressed in the lesion,it indicates that the patient may have immune deficiency or be in an immune dysregulated state,which has certain guiding significance for clinical diagnos

关 键 词：EB病毒 淋巴组织疾病 传染性单核细胞增多症 EBV核抗原2 

分 类 号：R733.4[医药卫生—肿瘤]