Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis.
Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma in the Elderly: A Matched Case-Control Analysis.
复制标题
老年人 Epstein-Barr 病毒阳性弥漫性大 B 细胞淋巴瘤：匹配病例对照分析
DOI：
10.1371/journal.pone.0133973
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Li ZM
中科院分区：
文献类型：
--
作者：
Song CG;Huang JJ;Li YJ;Xia Y;Wang Y;Bi XW;Jiang WQ;Huang HQ;Lin TY;Li ZM
背景eb病毒（EBV）阳性的弥漫性大b细胞淋巴瘤（DLBCL）在老年人中很少报道。本研究旨在探讨该疾病的临床特点及预后。方法对230例50岁以上连续新发DLBCL患者的肿瘤标本进行EBV原位杂交（ISH）和免疫组化分析。采用匹配病例对照分析（1:3）比较ebv阳性和ebv阴性的老年DLBCL。结果16例（7.0%）患者被诊断为ebv阳性DLBCL。16例患者中位年龄62岁，男女比例为11:5。老年ebv阳性DLBCL患者非生发中心b细胞（non-GCB）亚型发生率较高（87.5%），Ki67（75%）和CD30高表达（93.8%）。在接受初始化疗的ebv阳性患者中，16例患者中有7例（43.8%）完全缓解，2例（12.5%）部分缓解，2例（12.5%）病情稳定，5例（31.3%）病情进展。ebv阳性患者的中位总生存期为9个月。配对病例对照分析显示，ebv阳性患者的生存结果低于ebv阴性患者（3年无进展生存率[PFS]: 25% vs. 76.7%； 3年总生存率[OS]: 25% vs. 77.4%； P<0.001）。结论老年ebv阳性DLBCL患者临床病程较差，生存期较差。EBV在该疾病中的作用和该亚群的最佳管理值得进一步研究。
Background Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL) in the elderly has rarely been reported. This study aimed to explore the clinical characteristics and prognosis of this entity. Methods In situ hybridization (ISH) analysis of Epstein-Barr virus (EBV) and immunohistochemistry was performed in 230 tumor specimens from consecutive de novo DLBCL patients over 50 years old. A matched-case control analysis (1:3) was utilized to compare EBV-positive and EBV-negative DLBCL in the elderly. Results A total of 16 patients (7.0%) were diagnosed with EBV-positive DLBCL. Of these 16 cases, the median age was 62 years, with a male to female ratio of 11:5. Elderly EBV-positive DLBCL patients had a higher incidence of non-germinal center B-cell (non-GCB) subtypes (87.5%) and high Ki67 (75%) and CD30 expression (93.8%). For EBV-positive patients undergoing initial chemotherapy, 7 of 16 (43.8%) had complete remission, 2 (12.5%) had partial remission, 2 (12.5%) had stable disease, and 5 (31.3%) had progressive disease. The median overall survival was 9 months for the EBV-positive patients. A matched-case control analysis suggested that EBV-positive patients had inferior survival outcomes compared with EBV-negative patients (3-year progression-free survival [PFS]: 25% vs. 76.7%, respectively; 3-year overall survival [OS]: 25% vs. 77.4%, respectively; P<0.001). Conclusion EBV-positive DLBCL of the elderly is associated with an inferior clinical course and inferior survival outcomes. The role of EBV in this disease and the optimal management of this subgroup warrants further investigation.