Zuo Zhuo, Yang Qun-pei, Tang Yuan, Zhao Sha, Yu Jian-bo, Liu Yan-mei, Gao Li-min, Liu Wei-ping
Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China.
Zhonghua Bing Li Xue Za Zhi. 2013 Apr;42(4):227-33. doi: 10.3760/cma.j.issn.0529-5807.2013.04.004.
To analyze the clinicopathologic features of extranodal NK/T cell lymphoma, nasal type (ENKTCL-N), to explore the expression of NK cell-associated receptors in ENKTCL-N and the relationship with prognosis, and to establish a prognostic model.
One hundred and twenty-six cases of ENKTCL-N were selected from the files of the Department of Pathology, West China Hospital of Sichuan University. The relevant clinical and follow-up data were collected, and the histopathology was reviewed. All specimens were stained immunohistochemically for CD16, ICAM-1 and LFA-1. RT-PCR was used to detect the expression of CD94, NKG2 and KIR. The relationship between the prognosis of ENKTCL-N, clinical features, histopathological characteristics and expression of these markers were also analyzed.
ENKTCL-N mainly occurred in middle-age and young patients (median age, 41 years). The male to female ratio was 3.2:1. Sites more commonly involved were the nose and upper aerodigestive tract whereas those for the non-nasal type were the skin and gut. Only six cases involved two or more extranodal sites. Most (86.5%, 109/126) of the patients were in clinical stages I/II. The tumors showed predominately medium-sized tumor cells and large-sized tumor cells accounted for only 9.5% (12/126). Coagulative necrosis was present in all cases. The expression rates of CD56, CD16, CD94, LFA-1 and ICAM-1 were 82.6% (95/115), 15.1% (19/126), 55.4% (41/74), 40.5% (51/126) and 0, respectively. The expression rate of NKG2 receptor was 90.5% (67/74) overall. NKG2 receptor expression was independent of CD94. The overall expression rate of KIR receptor was 33.8% (25/74) and KIR receptor restriction was not detected in 20.8% (5/24) of the cases. Follow-up data was available in all patients, with median and average survival time being 15 months and 20.2 months, respectively. Survival analysis showed that prognostic factors included the gender, age, disease type, extranodal involvement, stage, the expression of CD16, LFA-1 and CD94. Cox's proportional hazard regression analysis revealed four factors, age, involved site, stage and CD16 expression, were independent prognostic factors.
The age, disease type, stage and CD16 expression are independent prognostic factors. Establishment of a prognostic model based on the above four factors can be more accurate in the prognostication of ENKTCL-N. The differences in the clinical features, prognosis, and expression of NK cell-associated receptors are obvious between nasal NK-cell lymphoma and non-nasal NK-cell lymphoma.
分析鼻型结外NK/T细胞淋巴瘤（ENKTCL-N）的临床病理特征，探讨NK细胞相关受体在ENKTCL-N中的表达及其与预后的关系，并建立预后模型。
从四川大学华西医院病理科档案中选取126例ENKTCL-N病例。收集相关临床及随访资料，并复习组织病理学。所有标本进行CD16、ICAM-1和LFA-1免疫组织化学染色。采用RT-PCR检测CD94、NKG2和KIR的表达。分析ENKTCL-N的预后与临床特征、组织病理学特征及这些标志物表达之间的关系。
ENKTCL-N主要发生于中青年患者（中位年龄41岁）。男女比例为3.2:1。较常累及的部位是鼻和上呼吸消化道，而非鼻型则为皮肤和肠道。仅6例累及两个或更多结外部位。大多数患者（86.5%，109/126）处于临床Ⅰ/Ⅱ期。肿瘤主要表现为中等大小的肿瘤细胞，大细胞仅占9.5%（12/126）。所有病例均有凝固性坏死。CD56、CD16、CD94、LFA-1和ICAM-1的表达率分别为82.6%（95/115）、15.1%（19/126）、55.4%（41/74）、40.5%（51/126）和0。NKG2受体总体表达率为9
