Delecluse H-J, Feederle R, O'Sullivan B, Taniere P
German Research Cancer Centre, Department of Virus Associated Tumours, Heidelberg, Germany.
J Clin Pathol. 2007 Dec;60(12):1358-64. doi: 10.1136/jcp.2006.044586. Epub 2007 Sep 14.
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).
爱泼斯坦 - 巴尔病毒（EBV）是一种疱疹病毒，与全球约1%的肿瘤相关。EBV是嗜B淋巴细胞病毒的典型代表，但其相关的肿瘤谱还扩展到T淋巴细胞和NK细胞恶性肿瘤、各种类型的癌以及平滑肌瘤。人类中普遍存在EBV感染意味着大多数个体都携带EBV感染的细胞。因此，仅仅在肿瘤患者中检测到该病毒不足以确立两者之间的因果关系，而是需要在肿瘤细胞中明确检测到病毒核酸或病毒蛋白。近期关于几种癌症中EBV感染的争议主要源于此类技术问题。金标准仍然是原位EBER检测，但检测EBNA1将是一个有趣的替代方法。EBV检测有助于诊断、预后评估和治疗。EBV与诸如鼻型NK/T细胞肿瘤等实体的关联率非常高，以至于在这样的病变中未检测到病毒应使人怀疑诊断的准确性。同样，EBV相关滤泡性假瘤的诊断显然需要检测到该病毒。EBV阳性的常见胃腺癌似乎比EBV阴性的预后更好，并且在免疫功能低下个体的B细胞淋巴增殖中鉴定该病毒将指导治疗选择。总之，EBV相关肿瘤很常见，在日常实践中对病理学家具有相关性，但需要促进病毒检测（例如EBNA1抗体）。
