Extranodal NK/T-cell lymphoma, nasal type: Study of clinicopathologic and prognosis factors in a series of 78 cases from Peru
Extranodal NK/T-cell lymphoma, nasal type: Study of clinicopathologic and prognosis factors in a series of 78 cases from Peru
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DOI：
10.1097/01.pai.0000205062.27174.56
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发表时间：
2007-03-01
影响因子：
1.6
通讯作者：
Zevallos-Giampietri, Eduardo-Alfredo
中科院分区：
文献类型：
--
作者：
Barrionuevo, Carlos;Zaharia, Mayer;Zevallos-Giampietri, Eduardo-Alfredo
淋巴结NK/T细胞淋巴瘤（NK/TCL）鼻型多见于亚洲国家。本研究分析了来自秘鲁的78例鼻NK/TCL病例。两个组织学组I（单形）和2（多态性），分离根据大细胞的比例（高于和低于30%，分别）。催化信号放大技术用于增强免疫组织化学反应性。用聚合酶链反应研究EB病毒（EBV）的序列和类型。评价两组患者的临床特征、分期、结局和治疗反应。14例病例（18%）和64例病例（82%）分别对应于I组和2组。除鼻塞在第2组中更常见外，所有其他症状在两组中相似。局部扩展和分期也具有可比性。两组均表现为CD 3c（+）CD 2（+）CD 56（+）CD 3s（-）CD 20（-）免疫表型。所有病例均为EBV阳性。在这个系列中，发现2型EBV比1型EBV更常见，与亚洲系列中观察到的相反。然而，大约三分之一的病例同时携带两种病毒类型。两组均接受平均50-戈伊剂量的放射治疗（RT），伴或不伴化疗。组I和组2的完全治疗反应率分别为89%和74%，但差异无统计学意义。在无病生存期、无失败生存期、复发和总生存期方面，两组之间没有显著差异。在两组中，单独接受RT治疗的患者的总生存期均长于接受联合RT治疗和化疗的患者。目前的研究表明，根据大细胞的频率，将鼻NK/TCL分为单态和多态性变体，与临床和预后因素无关。
It is well known that extranodal NK/T-cell lymphoma (NK/TCL) nasal type clusters in Asian countries. A large series of 78 cases of nasal NK/TCL from Peru is analyzed in the present study. Two histologic groups I (monomorphic) and 2 (polymorphic), were segregated according to the proportion of large cells (above and below 30%, respectively). Catalyzed signal amplification technique was performed for enhancement of immunohistochemistry reactivities. Epstein-Barr virus (EBV) sequences and types were investigated using polymerase chain reaction. Clinical characteristics, stage, outcome, and response to treatment were evaluated in both groups. Fourteen cases (18%) and 64 cases (82%) corresponded to groups I and 2, respectively. Except for nasal obstruction, more common in group 2, all other symptoms were similar in both groups. Local extension and staging were also comparable. Both groups showed CD3c(+)CD2(+)CD56(+)CD3s(-)CD20(-) immunophenotype. All cases were positive for EBV. In this series type-2 EBV was found more frequent than type-1 EBV, contrarily to that observed in Asian series. However, about one-third of cases simultaneously harbored both viral types. Both groups received an average of 50-Gy dose of radiation therapy (RT), with or without chemotherapy. Complete therapeutic response was achieved in 89% of group I and in 74% of group 2, but this difference was not statistically significant. There were no significant differences between the groups regarding disease-free survival, failure-free survival, relapse, and overall survival. The overall survival, in both groups, was longer for patients treated with RT alone compared with those treated with combined RT therapy and chemotherapy. The present study has shown that dividing nasal NK/TCL in monomorphic and polymorphic variants, according to frequency of large cells, does not correlate with clinical and prognostic factors.