Myriam Ben Dhiab, Sonia Ziadi, Hanene Saad, Teheni Louhichi, Mounir Trimeche
Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia.
Department of Pathology, University Hospital Farhat-Hached, Sousse 4000, Tunisia.
J Infect Chemother. 2017 Mar;23(3):121-130. doi: 10.1016/j.jiac.2016.09.004. Epub 2016 Dec 26.
The prognostic significance of Epstein-Barr virus (EBV) infection in Hodgkin lymphoma (HL) is still controversial. In this work we sought to examine the prognostic differences between EBV-positive and -negative HL through a series of 131 cases from Tunisia.
The status of EBV was assessed by EBV-encoded RNA (EBER) in situ hybridization. Results were correlated to patients' characteristics and outcome.
EBV was detected in the malignant cells in 62 of 131 HL cases (47.3%). EBV-positive HL was associated with extreme age classes (≤15 and > 45 years; p = 0.0001), male gender (p = 0.008), mixed cellularity histologic subtype (p = 0.03), and inversely with leukocytosis (white blood cells ≥15000/mm) (p = 0.004) and bulky mediastinum (mediastinal-thoracic ratio≥ 0.35) (p = 0.0001). On analysis of all patients, no significant difference between survival rates was found between EBV-positive and EBV-negative HL. In contrast, subgroups analysis revealed a negative effect of EBV infection in terms of overall survival in patients with Ann Arbor stages I/II (p = 0.03) and nodular sclerosis HL subgroup (p = 0.01), and in terms of event free survival in patients with mediastinal-thoracic ratio less than 0.35 (p = 0.03).
These results suggest that EBV infection affects the survival of particular subgroups of HL, especially those with early-stage of the disease.
爱泼斯坦-巴尔病毒（EBV）感染在霍奇金淋巴瘤（HL）中的预后意义仍存在争议。在本研究中，我们试图通过对来自突尼斯的131例病例进行分析，探讨EBV阳性和阴性HL之间的预后差异。
采用EBV编码RNA（EBER）原位杂交技术评估EBV状态。将结果与患者的特征和预后相关联。
131例HL病例中有62例（47.3%）在恶性细胞中检测到EBV。EBV阳性HL与极端年龄组（≤15岁和>45岁；p = 0.0001）、男性（p = 0.008）、混合细胞性组织学亚型（p = 0.03）相关，与白细胞增多（白细胞≥15000/mm）（p = 0.004）和巨大纵隔（纵隔-胸廓比值≥0.35）（p = 0.0001）呈负相关。对所有患者进行分析时，EBV阳性和阴性HL的生存率之间未发现显著差异。相反，亚组分析显示，EBV感染对Ann Arbor I/II期患者（p = 0.03）和结节硬化型HL亚组患者（p = 0.01）的总生存有负面影响，对纵隔-胸廓比值小于0.35的患者的无事件生存有负面影响（p = 0.03）。
这些结果表明，EBV感染影响HL特定亚组的生存，尤其是疾病早期的患者。
