Gulley Margaret L, Tang Weihua
Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599-7525, USA.
J Mol Diagn. 2008 Jul;10(4):279-92. doi: 10.2353/jmoldx.2008.080023. Epub 2008 Jun 13.
Epstein-Barr virus (EBV) infects various cell types in a wide spectrum of benign and malignant diseases. Laboratory tests for EBV have improved and are increasingly used in diagnosis, prognosis, prediction, and prevention of diseases ranging from infectious mononucleosis to selected subtypes of lymphoma, sarcoma, and carcinoma. Indeed, the presence of EBV is among the most effective tumor markers supporting clinical management of cancer patients. In biopsies, localization of EBER transcripts by in situ hybridization remains the gold standard for identifying latent infection. Other RNA- and protein-based assays detect lytic viral replication and can distinguish carcinoma-derived from lymphocyte-derived EBV in saliva or nasopharyngeal brushings. Analysis of blood using EBV viral load and serology reflects disease status and risk of progression. This review summarizes prior research in the context of basic virologic principles to provide a rational strategy for applying and interpreting EBV tests in various clinical settings. Such assays have been incorporated into standard clinical practice in selected settings such as diagnosis of primary infection and management of patients with immune dysfunction or nasopharyngeal carcinoma. As novel therapies are developed that target virus-infected cells or overcome the adverse effects of infection, laboratory testing becomes even more critical for determining when intervention is appropriate and the extent to which it has succeeded.
爱泼斯坦-巴尔病毒（EBV）在广泛的良性和恶性疾病中感染多种细胞类型。EBV的实验室检测方法已经改进，并越来越多地用于从传染性单核细胞增多症到某些淋巴瘤、肉瘤和癌亚型等疾病的诊断、预后评估、预测和预防。事实上，EBV的存在是支持癌症患者临床管理的最有效的肿瘤标志物之一。在活检中，通过原位杂交定位EBER转录本仍然是识别潜伏感染的金标准。其他基于RNA和蛋白质的检测方法可检测病毒的裂解复制，并能区分唾液或鼻咽刷片中癌源性和淋巴细胞源性的EBV。利用EBV病毒载量和血清学分析血液可反映疾病状态和进展风险。本综述在基本病毒学原理的背景下总结了先前的研究，以提供在各种临床环境中应用和解释EBV检测的合理策略。此类检测已被纳入某些特定临床实践标准，如原发性感染的诊断以及免疫功能障碍或鼻咽癌患者的管理。随着针对病毒感染细胞或克服感染不良反应的新型疗法的开发，实验室检测对于确定何时进行干预以及干预成功的程度变得更加关键。
