Expression of Epstein-Barr virus in Hodgkin lymphoma in a population of United Arab Emirates nationals
Expression of Epstein-Barr virus in Hodgkin lymphoma in a population of United Arab Emirates nationals
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DOI：
10.1080/10428190802270894
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发表时间：
2008-01-01
影响因子：
2.6
通讯作者：
Castella, Antonio
中科院分区：
文献类型：
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作者：
Al-Salam, Suhail;John, Anne;Castella, Antonio
霍奇金淋巴瘤（HL）在组织学亚型及其与eb病毒（EBV）的关系上表现出广泛的地理差异。HL有三种主要流行病学模式（I、II和III）。在发展中国家普遍存在的第一类模式，在男孩中发病率相对较高，在第三个十年发病率较低，在老年群体中发病率较高的第二个高峰。III型通常见于发达国家，其特点是儿童发病率低，在年轻人中出现明显的初始高峰。许多亚洲国家描述的第三种模式（II型）是中间的，反映了I型和III型之间的过渡。在这种模式下，有童年和第三个十年的高峰。EBV阳性HL的比例在工业化国家低，在非工业化国家高，在早期工业化国家中等。来自阿拉伯海湾和中东的报道很少。本研究的目的是确定阿拉伯海湾早期工业化国家阿拉伯联合酋长国（UAE）国民人群中HL的流行病学，并描述其与EBV的关联程度。在1988年至2004年期间，共有88例HL在Tawam医院的本地患者中被诊断出来。45个石蜡块可用于本研究。制备5微米切片，用苏木精、伊红和免疫组化链亲和素生物素法对CD45、CD3、CD20、CD15和CD30进行染色。使用免疫组织化学链亲和素-生物素法检测潜伏膜蛋白1和EBV编码RNA的原位杂交，检测其他切片是否存在EBV，以确定EBV在霍奇金细胞中的流行程度及其在HL发病机制中的可能作用。结节硬化（NS）亚型是阿联酋国民中最常见的HL类型，其次是混合细胞型（MC）、淋巴细胞显性型（LP）、未分类型、淋巴细胞耗损型（LD）和淋巴细胞丰富型（LR）亚型。45例HL患者中有17例（38%）出现EBV，主要见于MC亚型，其次分别为NS、LD和LR亚型。EBV在儿童年龄组的HL中表达频率高于成人年龄组。这些数据表明，就年龄分布和组织病理学亚型而言，阿联酋本地人群中HL的流行病学倾向于II型流行病学模式，而EBV的表达频率更倾向于III型流行病学模式。我们发现EBV和HL之间的显著关联进一步加强了对所有HL病例进行EBV状态评估的建议，因为它的存在可能对预后和治疗反应有重大影响。
Hodgkin lymphoma (HL) shows wide geographic variation in histological subtypes and in its association with the Epstein-Barr virus (EBV). HL has three main epidemiological patterns (I, II and III). Type I pattern, which is prevalent in developing countries, shows a relatively high incidence in male children, a low incidence in the third decade and a second peak of high incidence in older age groups. Type III, which is usually seen in developed countries, is characterised by a low rate in children and a pronounced initial peak in young adults. The third pattern (Type II), which is described in many Asian countries, is intermediate and reflects a transition between types I and III. In this pattern there is both a childhood and a third decade peak. The proportion of EBV positive HL is low in industrialised countries, high in non-industrialised countries and intermediate in early-industrialised countries. Reports from the Arabian Gulf and Middle East are few. The aim of this study is to determine the epidemiology of HL in a population of United Arab Emirates (UAE) nationals, an early industrialised country in the Arabian Gulf, and to delineate the extent of its association with EBV. In total, 88 cases of HL were diagnosed in native patients during the period 1988 through 2004 at Tawam hospital. Forty-five paraffin blocks were available for this study. Five-micrometer sections were prepared and stained with hematoxylin and eosin and the immunohistochemical streptavidin-biotin methods for CD45, CD3, CD20, CD15 and CD30. Other sections were examined for the presence of EBV using the immunohistochemical streptavidin-biotin method for the latent membrane protein 1 and in situ hybridisation for EBV encoded RNA to determine the prevalence of EBV in Hodgkin cells and its possible role in the pathogenesis of HL. Nodular sclerosis (NS) subtype was the most common type of HL among UAE nationals followed by mixed cellularity (MC), lymphocytic predominant (LP), unclassified, lymphocytic depletion (LD) and lymphocyte rich (LR) subtypes, respectively. EBV was seen in 17 of 45 (38%) cases of HL and was predominately seen in the MC subtype followed by NS, LD and LR subtypes, respectively. EBV was more frequently expressed in HL in the pediatric age group than the adult age group. These data indicate that the epidemiology of HL in a native population of the UAE is suggestive of a type II epidemiologic pattern in terms of age distribution, and histopathologic subtypes, whereas the frequency of EBV expression is more suggestive of a type III epidemiologic pattern. The significant association between EBV and HL that we have found further strengthens the suggestion that all cases of HL should be assessed for EBV status, because its presence may have a significant impact on prognosis and response to therapy.