Federal University of São Paulo (UNIFESP), Hematology and Transfusion Service, São Paulo, SP, Brazil.
Hematol Oncol. 2010 Sep;28(3):137-41. doi: 10.1002/hon.933.
Classical Hodgkin's Lymphoma (cHL) has been frequently associated with Epstein-Barr virus (EBV), which can be found in a latent pattern in Reed-Sternberg (RS) cells. However, the impact of the presence of EBV in RS cells and its prognosis are still controversial. We analysed the presence of EBV in RS cells and its influence in the clinical evolution of patients with cHL treated in two public hospitals in the city of São Paulo, Brazil.
We selected 97 patients with cHL from 1994 to 2004. Patients were only included in this study if they had (1) >18 years, (2) negative HIV serology, (3) undergone similar chemotherapy protocols, (4) paraffin blocks available with enough material for systematic review and histological reclassification and for detection of EBV in RS cells by in situ hybridization and immunohistochemistry and (5) clinical, epidemiological and laboratorial parameters available after a thorough chart review.
EBV was identified in 52.5% of the cases. Mixed cellularity (MC) subtype was more common in EBV-related tumours (25.5%) (p=0.005). There was no difference on age, gender, stage and the presence of B symptoms between the two groups. The presence of EBV did not influence event free survival (EFS) (p=0.38) or overall survival (OS) (p=0.80) with a median follow-up of 80 months.
We demonstrate that the prevalence of EBV-related cHL in this Brazilian population is 52.5% and, that, the presence of EBV does not change the clinical evolution and OS of patients treated with similar chemotherapy protocols.
经典型霍奇金淋巴瘤（cHL）常与 Epstein-Barr 病毒（EBV）相关，后者可在 Reed-Sternberg（RS）细胞中以潜伏形式存在。然而，RS 细胞中 EBV 的存在及其预后的影响仍存在争议。我们分析了 EBV 在 RS 细胞中的存在及其对巴西圣保罗市两家公立医院治疗的 cHL 患者临床转归的影响。
我们从 1994 年至 2004 年选择了 97 例 cHL 患者。只有符合以下条件的患者才被纳入本研究：（1）>18 岁，（2）HIV 血清学阴性，（3）接受类似的化疗方案，（4）有足够的石蜡块用于系统评价和组织学重新分类，以及通过原位杂交和免疫组织化学检测 EBV 在 RS 细胞中的存在，（5）通过详细的图表审查后获得临床、流行病学和实验室参数。
在 52.5%的病例中鉴定出 EBV。EBV 相关肿瘤中更常见混合细胞性（MC）亚型（25.5%）（p=0.005）。两组间在年龄、性别、分期和 B 症状的存在方面无差异。EBV 的存在并不影响无事件生存（EFS）（p=0.38）或总生存（OS）（p=0.80），中位随访 80 个月。
我们证明，在这个巴西人群中，EBV 相关 cHL 的患病率为 52.5%，并且，在接受类似化疗方案治疗的患者中，EBV 的存在不会改变临床转归和 OS。
