Carbone Antonino, Volpi Chiara C, Gualeni Ambra V, Gloghini Annunziata
aDepartment of Pathology, Centro di Riferimento Oncologico Aviano (CRO), Istituto Nazionale Tumori, IRCCS, Aviano bDepartment of Diagnostic Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Curr Opin HIV AIDS. 2017 Jan;12(1):39-46. doi: 10.1097/COH.0000000000000333.
The present review summarizes the association of the different histotypes of Epstein-Barr virus (EBV)-associated lymphomas with known genetic lesions and/or oncogenic viruses. A more comprehensive understanding of the complex interplay existing between genetic abnormalities of tumor cells and the viral contribution to the development of EBV-associated lymphomas is pivotal for the development of more effective treatments.
Recent evidence indicates that HIV may contribute to lymphomagenesis by acting directly on B lymphocytes as a critical microenvironmental factor. The pathogenesis of EBV-associated lymphomas in patients with HIV infection is considered the result of the concerted action of different factors, mainly including impaired immune surveillance, genetic alterations, and concomitant viral infection (EBV and HIV).
Immunodeficiency states usually increase susceptibility to cancer as a result of reduced immune surveillance and enhanced chances for virus-driven oncogenesis. Lymphoma remains the most frequent neoplastic cause of death among patients infected with HIV. Several of the HIV-associated lymphomas are related to EBV infection. EBV-associated lymphomas in patients infected with HIV are heterogeneous, not only pathologically but also in terms of pathogenetic pathways and cellular derivation.
本综述总结了爱泼斯坦-巴尔病毒（EBV）相关淋巴瘤的不同组织学类型与已知基因损伤和/或致癌病毒之间的关联。更全面地了解肿瘤细胞基因异常与病毒在EBV相关淋巴瘤发生发展中的作用之间存在的复杂相互作用，对于开发更有效的治疗方法至关重要。
最近的证据表明，HIV可能作为关键的微环境因素直接作用于B淋巴细胞，从而促进淋巴瘤的发生。HIV感染患者中EBV相关淋巴瘤的发病机制被认为是不同因素共同作用的结果，主要包括免疫监视受损、基因改变以及并发病毒感染（EBV和HIV）。
免疫缺陷状态通常会因免疫监视减弱和病毒驱动的肿瘤发生机会增加而增加患癌易感性。淋巴瘤仍然是HIV感染患者中最常见的肿瘤致死原因。几种与HIV相关的淋巴瘤与EBV感染有关。HIV感染患者中的EBV相关淋巴瘤具有异质性，不仅在病理方面，而且在发病机制途径和细胞来源方面也是如此。
