Lee W Y, Hsiao J R, Jin Y T, Tsai S T
Department of Pathology, National Cheng Kung University Medical College, Tainan, Taiwan.
Head Neck. 2000 Jul;22(4):336-40. doi: 10.1002/1097-0347(200007)22:4<336::aid-hed4>3.0.co;2-t.
Nasopharyngeal carcinoma (NPC) is strongly associated with Epstein-Barr virus (EBV). The metastasis to cervical lymph nodes represents a frequent initial manifestation of NPC. The usefulness of EBV detection by polymerase chain reaction (PCR) in the diagnosis of occult NPC with cervical metastasis has been reported. Our previous study showed that EBER1 in-situ hybridization was somewhat more sensitive and specific than PCR in detecting EBV in the evaluation of specimens from a population at high risk for NPC.
Fine-needle aspiration cytologic specimens of neck masses from 30 patients were investigated, including 10 NPC primary tumors, 19 squamous cell carcinomas from other sites of the head and neck (9 oral cavity, 2 paranasal sinuses, 2 oropharynx, 3 larynx, and 3 hypopharynx), and 1 diffuse large-cell lymphoma. EBER1 in-situ hybridization was performed on direct smears made from aspirates.
EBER1 signals were detected in all neck metastases from the nasopharynx but none of the specimens from other primary sites.
This study suggests that EBER1 in-situ hybridization can be used as a supplemental tool for differential diagnosis whenever fine-needle aspiration cytologic examination is presented with a neck metastasis without knowing the primary site.
鼻咽癌（NPC）与爱泼斯坦-巴尔病毒（EBV）密切相关。颈部淋巴结转移是鼻咽癌常见的初始表现。聚合酶链反应（PCR）检测EBV在诊断伴有颈部转移的隐匿性鼻咽癌中的作用已有报道。我们之前的研究表明，在评估鼻咽癌高危人群的标本时，EBER1原位杂交在检测EBV方面比PCR更敏感、更具特异性。
对30例患者颈部肿块的细针穿刺细胞学标本进行研究，其中包括10例鼻咽癌原发肿瘤、19例头颈部其他部位的鳞状细胞癌（9例口腔、2例鼻窦、2例口咽、3例喉和3例下咽）以及1例弥漫性大细胞淋巴瘤。对穿刺抽吸物制成的直接涂片进行EBER1原位杂交。
在所有鼻咽癌颈部转移灶中均检测到EBER1信号，但其他原发部位的标本均未检测到。
本研究表明，当细针穿刺细胞学检查出现不明原发部位的颈部转移时，EBER1原位杂交可作为鉴别诊断的辅助工具。
