Epstein-Barr virus-associated tumours: an update for the attention of the working pathologist
Epstein-Barr virus-associated tumours: an update for the attention of the working pathologist
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DOI：
10.1136/jcp.2006.044586
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发表时间：
2007-12-01
影响因子：
3.4
通讯作者：
Taniere, P.
中科院分区：
文献类型：
--
作者：
Delecluse, H-J;Feederle, R.;Taniere, P.
EB病毒（EBV）是一种疱疹病毒，与全球约1%的肿瘤相关。EBV是亲B淋巴细胞病毒的表位，但其相关的肿瘤谱延伸至T淋巴细胞和NK细胞恶性肿瘤、各种类型的癌和平滑肌肿瘤。在人类中普遍存在的EBV感染意味着大多数个体携带EBV感染的细胞。因此，仅仅在肿瘤患者中检测到病毒不足以建立两种事件之间的因果关系，而是需要明确检测肿瘤细胞中的病毒核酸或病毒蛋白。最近关于EBV感染在几种癌症中的争议主要是由于这些技术问题。金标准仍然是原位EBER检测，但EBNA 1的检测将是一个有趣的替代方案。EBV检测可有助于诊断、预后和治疗目的。EB病毒与鼻型NK/T细胞肿瘤等实体的相关率如此之高，以致于在这种病变中检测不到病毒，应引起对诊断准确性的怀疑。同样，EBV相关的滤泡性假瘤的诊断显然需要检测病毒。EBV阳性的普通胃腺癌似乎比EBV阴性的胃腺癌有更好的预后，在免疫功能低下的个体中识别B细胞淋巴增殖中的病毒将指导治疗选择。总之，EBV相关肿瘤很常见，足以在日常实践中与病理学家相关，但需要促进病毒（如EBNA 1抗体）的检测。
Epstein-Barr virus (EBV) is a herpesvirus associated with approximately 1% of tumours worldwide. EBV is the epitome of B lymphotropic viruses, but the spectrum of tumours it is associated with extends to T lymphocyte and NK cell malignancies, various types of carcinomas and smooth muscle tumours. Ubiquitous EBV infection in humans implies that most individuals carry EBV-infected cells. Therefore, mere detection of the virus in individuals with a tumour is not sufficient for establishing a causal relationship between both events, but instead requires unequivocal detection of viral nucleic acids or viral proteins in the tumour cells. Recent controversies about EBV infection in several carcinomas mainly resulted from such technical issues. The gold standard remains in situ EBER detection, but detection of EBNA1 would be an interesting alternative. EBV detection can be helpful for diagnostic, prognostic and therapeutic purposes. The rate of EBV association with entities such as NK/T cell tumours of the nasal type is so high that absence of detection of the virus in such a lesion should cast doubt of the accuracy of the diagnosis. Similarly, diagnosis of EBV-associated follicular pseudo-tumour obviously requires detection of the virus. EBV-positive common gastric adenocarcinomas seem to have a better prognosis than their EBV-negative counterparts and identification of the virus in B cell lymphoproliferations in immunocompromised individuals will guide therapeutic options. In conclusion, EBV-associated tumours are common enough to be relevant for the pathologist in everyday practice, but there is a need to facilitate detection of the virus (eg EBNA1 antibody).