摘要
目的分析不同临床特征的非霍奇金淋巴瘤(Non-Hodgkin's lymphoma,NHL)患者外周血单个核细胞EB病毒DNA(Epstein-Barr virus DNA,EBV-DNA)载量的差异,探讨其在监测患者预后中的临床应用价值。方法回顾性分析2017年4月~2020年9月在中国科技大学附属第一医院西区就诊的421例非霍奇金淋巴瘤患者的EBV-DNA在不同年龄、性别、病理类型、临床分期、淋巴瘤B症状、预后指数IPI、临床常见检测指标等方面的差异。分析连续定期随访的97例NHL患者治疗前后的EB病毒载量变化,讨论EBV-DNA在患者预后中的意义。结果421例NHL患者外周血单个核细胞EBV-DNA阳性率为41.8%,阳性率随着患者年龄增加而不断增高,其中T和NK细胞来源的以及有淋巴瘤B症状的NHL患者更易受感染,且不同组织来源的NHL患者感染率也有明显差异。97例随访NHL患者按照IPI分为四组,低危组、低中危组和高中危组治疗后EBV-DNA载量明显下降,而高危组治疗后载量无明显变化。EB病毒感染后的NHL患者前白蛋白、白蛋白、视黄醇结合蛋白明显低于未感染者,且风险较高,生存时间较短。临床指标中病理类型、EBV感染、淋巴瘤B症状、有无骨髓浸润、PA和CysC与预后显著相关,其中病理类型、EBV感染、有无骨髓浸润和CysC是NHL的独立预后因素,成熟T和NK细胞来源NHL患者预后更差。结论不同类型NHL患者外周血单个核细胞中EBV-DNA载量具有差异,治疗前后定期检测患者EB病毒载量变化对预后监测有一定的临床应用价值。
Objective To analyze the differences of Epstein-Barr virus(EBV)DNA in peripheral blood mononuclear cells(PBMCs)of patients with non-Hodgkin's lymphoma(NHL),and to discuss its clinical applications in prognosis.Methods A retrospective analysis of 421 NHL patients from the Western Branch of the First Affiliated Hospital of University of Science and Technology of China between April 2017 and September 2020 were conducted.The following clinical information was collected:age,sex,pathological type,clinical stage,lymphoma B symptoms,NHL international prognostic index(IPI),the results of blood routine and biochemical.Ninety-seven NHL patients were followed up regularly to a nalyze the changes of EBV DNA load before and after treatment to discuss its significance in the prognosis.Results The positive rate of EBV DNA from PBMCs in 421 NHL patients was 41.8%.The EBV DNA positive rate increased with age.Among them,NHL patients with T and NK cells and with lymphoma B symptoms were more susceptible to EBV infection,and the infection rate of patients with different tissue sources was also significantly different.According to International prognostic index,97 NHL patients were divided into four groups.After treatment,EBV DNA load in the low-risk group,low-medium-risk group and middle-risk group decreased significantly,while the load in the high-risk group did not change significantly.The prealbumin(PA),albumin(ALB),and retinol binding protein(RBP)in NHL patients after EBV infection are significantly lower than those in uninfected patients,and the risk was higher and the survival time was shorter.Among the clinical indicators,pathological types,EBV infection,lymphoma B symptoms,bone marrow infiltration,PA and CysC were significantly correlated with the prognosis of patients.And pathological types,EBV infection,bone marrow infiltration and CysC were found to be independent prognostic factors in NHL.Patients with NHL derived from mature T and NK cells had poor prognosis.Conclusion Different types of NHL patients had differences in EBV DNA in PBMCs.Regular EBV DNA load monitoring before and after therapy could be clinical application value for prognosis monitoring.
作者
张扬
戴春阳
华艳
陈少华
陈兆武
李明
ZHANG Yang;DAI Chun-yang;HUA Yan(Department Clinical Laboratory,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China(Anhui Provincial Cancer Hospital),Hefei 230031)
出处
《临床输血与检验》
CAS
2021年第3期350-359,共10页
Journal of Clinical Transfusion and Laboratory Medicine
基金
安徽省自然科学基金面上项目(No.006162982003)资助。
关键词
EB病毒DNA
非霍奇金淋巴瘤
临床特征
预后
Epstein-Barr virus DNA
Non-Hodgkin's lymphoma
Clinical features prognosis
作者简介
张扬(1986-),女,安徽淮南人,主治医师,硕士,主要从事肿瘤的分子及个体化检测方面研究,(E-mail)zhangyang_0912@163.com;通信作者:李明,男,副主任技师,博士,主要从事肿瘤免疫治疗的液态活检方面研究,(E-mail)liming19831002@163.com。
