THE ASSOCIATION OF EPSTEIN-BARR-VIRUS WITH SMOOTH-MUSCLE TUMORS OCCURRING AFTER ORGAN-TRANSPLANTATION
THE ASSOCIATION OF EPSTEIN-BARR-VIRUS WITH SMOOTH-MUSCLE TUMORS OCCURRING AFTER ORGAN-TRANSPLANTATION
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DOI：
10.1056/nejm199501053320104
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发表时间：
1995-01-05
影响因子：
158.5
通讯作者：
DICKMAN, PS
中科院分区：
文献类型：
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作者：
LEE, ES;LOCKER, J;DICKMAN, PS
背景EB病毒（Epstein-Barr virus，EBV）与鼻咽癌、某些淋巴瘤和器官移植后的淋巴组织增生性疾病有关。移植后发生的许多淋巴增生性肿瘤是克隆性的，这一特性将其归类为肿瘤。克隆性可以通过分析EBV感染产生的染色体外环状DNA附加体来确定。我们描述了三个年轻的儿童，其中平滑肌肿瘤发展18个月至5 1/2年后，肝移植免疫抑制，我们检查了肿瘤显微镜和免疫组化研究和分子遗传学分析的EBV DNA。肿瘤由梭形细胞组成，具有平滑肌特征，与获得性免疫缺陷综合征患者中描述的相似。免疫组化分析EBV潜伏膜蛋白和EBV受体（CD 21）阴性，但EBV核抗原2阳性。原位杂交结果显示3例患者均为EB病毒核基因组，分子遗传学分析显示3例患者均为克隆性EB病毒。器官移植后发生的平滑肌肿瘤含有克隆性EBV，表明该病毒在这些肿瘤性病变的发展中起作用。
Background. Epstein-Barr virus (EBV) has been associated with nasopharyngeal carcinoma, some lymphomas, and lymphoproliferative disease after organ transplantation. Many lymphoproliferative tumors that occur after transplantation are clonal, a property that classifies them as neoplastic. Clonality can be determined by analysis of the extrachromosomal circular DNA episomes produced by EBV infection.Methods. We describe three young children in whom smooth-muscle tumors developed 18 months to 5 1/2 years after liver transplantation with immunosuppression, We examined the tumors by microscopy and with immunohistochemical studies and molecular genetic analyses of the EBV DNA.Results. The tumors were composed of spindle cells with smooth-muscle features and resembled those described in patients with the acquired immunodeficiency syndrome, Immunohistochemical analysis was negative for EBV latent membrane protein and EBV receptor (CD21), but positive for EBV nuclear antigen 2. In situ hybridization revealed nuclear EBV sequences, and molecular genetic analysis showed the EBV genome to be clonal in all three patients.Conclusions. Smooth-muscle tumors that developed after organ transplantation contained clonal EBV, suggesting that the virus has a role in the development of these neoplastic lesions.