Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Uppsala, Sweden.
Am J Transplant. 2014 Dec;14(12):2838-45. doi: 10.1111/ajt.12990. Epub 2014 Oct 10.
Previous studies of donor or recipient origin of posttransplant lymphoproliferative disorders (PTLDs) following solid organ transplantation (SOT) have either been small or with selected patient groups. We studied tumor origin in a population-based cohort of 93 patients with PTLD following SOT. Tumor origin of PTLD tissue was analyzed by fluorescence in situ hybridization of the sex chromosomes in cases of sex mismatch between donor and recipient (n = 41), or HLA genotyping in cases of identical sex but different HLA type (n = 52). Tumor origin of PTLD could be determined in 67 of the 93 cases. All 67 PTLDs were of recipient origin. They were found in recipients of kidney (n = 38), liver (n = 12), heart (n = 10) and lung (n = 7). The most common recipient-derived lymphomas were monomorphic B-cell PTLDs (n = 45), monomorphic T cell PTLDs (n = 9), indolent lymphomas (n = 6), and polymorphic PTLD (n = 4). Half of the recipient-derived PTLDs were Epstein-Barr virus-positive. Twelve of the recipient-derived PTLDs were located in the grafts: in four cases exclusively and in eight cases in combination with disseminated disease outside the graft. Tumor origin was indeterminable in 26 cases, probably due to low DNA quality. We conclude that the vast majority of PTLDs after SOT was of recipient origin.
先前关于实体器官移植（SOT）后发生的移植后淋巴组织增生性疾病（PTLD）供体或受体起源的研究要么规模较小，要么只针对特定的患者群体。我们研究了 SOT 后发生 PTLD 的 93 例基于人群队列患者的肿瘤起源。通过对供体和受体之间性别不匹配的 41 例病例（n=41）进行性染色体荧光原位杂交，或对相同性别的但 HLA 类型不同的 52 例病例（n=52）进行 HLA 基因分型，分析 PTLD 组织的肿瘤起源。在 93 例病例中的 67 例可以确定 PTLD 的起源。这 67 例 PTLD 均来源于受体。它们发生在肾移植（n=38）、肝移植（n=12）、心脏移植（n=10）和肺移植（n=7）受体中。最常见的受体衍生淋巴瘤是单形 B 细胞 PTLD（n=45）、单形 T 细胞 PTLD（n=9）、惰性淋巴瘤（n=6）和多形性 PTLD（n=4）。半数受体衍生的 PTLD 呈 EBV 阳性。12 例受体衍生的 PTLD 位于移植物中：4 例为移植物内唯一受累，8 例为移植物内与播散性疾病并存。26 例病例的肿瘤起源无法确定，可能是由于 DNA 质量较低。我们得出结论，SOT 后发生的 PTLD 绝大多数来源于受体。
