Determination of Epstein-Barr Virus-Infected Lymphocyte Cell Types in Peripheral Blood Mononuclear Cells as a Valuable Diagnostic Tool in Hematological Diseases
Determination of Epstein-Barr Virus-Infected Lymphocyte Cell Types in Peripheral Blood Mononuclear Cells as a Valuable Diagnostic Tool in Hematological Diseases
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测定外周血单核细胞中 Epstein-Barr 病毒感染的淋巴细胞类型，作为血液疾病的宝贵诊断工具
DOI：
10.1093/ofid/ofz171
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发表时间：
2019-05-01
影响因子：
4.2
通讯作者：
Zhou, Jianfeng
中科院分区：
文献类型：
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作者：
Zhang, Peiling;Zeng, Chen;Zhou, Jianfeng
背景外周血单个核细胞（PBMC）中高负荷的EB病毒（EBV）可以指示广谱疾病，从无症状感染到致命的癌症。我们回顾性调查了291例患者PBMC中EBV感染的细胞类型。根据EB病毒感染细胞类型，分析了5年来93例EB病毒相关（EBV+）T/NK细胞淋巴组织增生性疾病（T/NK-LPDs）的临床特征和预后。尽管在免疫功能低下患者和无症状高EBV携带、传染性单核细胞增多症、EBV+ B细胞LPD和B细胞淋巴瘤患者中发现B细胞型感染，但在免疫功能正常的宿主中发现T细胞、NK细胞或多细胞型感染高度提示EBV+ T/NK-LPD、EBV+ T/NK细胞淋巴瘤和侵袭性NK细胞白血病。非B细胞感染的患者预后比B细胞型感染的患者差。在我们的队列中，79.6%的EBV+ T/NK-LPD患者年龄>18岁，54.8%的NK细胞被鉴定为EBV感染的细胞类型。近一半的EBV+ T/NK-LPD患者存在与免疫缺陷相关的遗传缺陷。然而，噬血细胞性淋巴组织细胞增生症，而不是遗传缺陷，是与EBV+ T/NK-LPDs预后不良相关的唯一参数。确定PBMC中EBV感染的细胞类型是鉴别诊断EBV+血液病的有价值的工具。
Background. High loads of Epstein-Barr virus (EBV) in peripheral blood mononuclear cells (PBMCs) can be indicative of a broad spectrum of diseases, ranging from asymptomatic infection to fatal cancers.Methods. We retrospectively investigated the EBV-infected cell types in PBMCs among 291 patients. Based on EBV-infected cell types, the clinical features and prognoses of 93 patients with EBV-associated (EBV+) T/natural killer (NK)-cell lymphoproliferative diseases (LPDs) T/NK-LPDs) were investigated over a 5-year period.Results. Although B-cell-type infection was found in immunocompromised patients and patients with asymptomatic high EBV carriage, infectious mononucleosis, EBV+ B-cell LPDs and B-cell lymphomas, T-cell, NK-cell or multiple-cell-type infection in immunocompetent hosts were highly suggestive of EBV+ T/NK-LPDs, EBV+ T/NK-cell lymphomas, and aggressive NK-cell leukemia. Patients with non-B-cell infection had a poorer prognosis than those with B-cell-type infection. In our cohort, 79.6% of patients with EBV+ T/NK-LPDs were >18 years old, and NK cells were identified as EBV-infected cell type in 54.8%. Nearly half of patients with EBV+ T/NK-LPDs had genetic defects associated with immunodeficiency. However, hemophagocytic lymphohistiocytosis, and not genetic defects, was the only parameter correlated with poor prognosis of EBV+ T/NK-LPDs.Conclusions. Determination of EBV-infected cell types among PBMCs is a valuable tool for the differential diagnosis of EBV+ hematological diseases.