IMMUNOLOGIC, GENETIC AND EPSTEIN-BARR VIROLOGICAL STUDIES OF MALIGNANCIES IN HEAD AND NECK LESION

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1) First, we investigated phenotypic, genotypic and Epstein-Barr virus (EBV) features of nasal T-cell lymphomas (NTL). We found that that NTL may be derived from the lineage of NK or N K-like T-cells and that EBV may play a role in the lymphomagenesis.2) The levels of soluble intercellular adhesion molecule-1 (ICAM-1) were significantly higher in NTL than that in other head and neck lymphomas as well as that in healthy adult controls. The intense expression of the ICAM-1 was found in the tissues from NTL.These data may be one of the clue to an understanding of this particular lymphoma.3) Analyses of prognostic factors non-Hodgkin's lymphoma of Waldeyer's ring revealed that prognosis was associated with primary disease in the base of tongue, stage III-IV, B-symptoms, highly histologic grade, T-cell phenotype, elevated LDH levels, decreased peripheral blood lymphocytes counts, or negative response on delayed type hypersensitivity skin reactions. Multivariate analysis showed that both stage III-IV and T-cell phenotype were significant independent risk factor for death.4) Finally, we examined the presence of EBV in the lymphomas of sino-nasal region and determined its relation with clinical, phenotypic, and genotypic features. Twenty-three patients with nasal lymphomas had pan T-antigens MT1 and/or CD2 ; while all 7 sinus lymphomas displayed pan B-antigen L26. EBER transcripts were identified in 20 of 23 patients with NTL, but was never detected in sinus lymphomas. The natural killer (NK) cell phenotype CD56, monoclonal EBV genome, EBNA1, and LMP1, were detected in all EBER-positive NTL tested. The rearrangements of T-cell receptor (TCR) genes were shown in 11 of 1 3 NTL tested. NTL showed significantly lower survival rates as compared to the other types of sino-nasal lymphomas.