Clark J W, Gurgo C, Franchini G, Gibbs W N, Lofters W, Neuland C, Mann D, Saxinger C, Gallo R C, Blattner W A
Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892.
Cancer. 1988 Apr 1;61(7):1477-82. doi: 10.1002/1097-0142(19880401)61:7<1477::aid-cncr2820610735>3.0.co;2-x.
As part of epidemiologic studies of human T-lymphotropic virus (HTLV)-I-associated malignancies in Jamaica, the authors evaluated 26 patients with non-Hodgkin's lymphoma for the presence of integrated HTLV-I provirus in their malignant cells. Fifteen of 26 patients had integrated provirus. All 15 also were HTLV-I antibody positive. Eleven patients did not have integrated provirus, and all 11 were antibody negative. All of the antibody-positive cases had onset of their disease in adulthood (age range, 21-57 years) as opposed to the broad age range of negative cases (4-66 years). Clinical features which were more common in provirus positive than negative patients included leukemic phase, skin involvement, and hypercalcemia, which are all features frequently seen in HTLV-I-associated adult T-cell leukemia/lymphoma (ATLL). The presence of skin involvement, circulating malignant cells, abnormal liver function tests, or the presence of two or more of these four features were statistically significantly different between virus-positive and virus-negative cases. Although the survival of positive cases (6 months) was shorter than that of negative cases (9 months), this was not statistically significant. The only significant determinant of survival was hypercalcemia, with those who developed hypercalcemia at some point in their disease course, independent of their HTLV-I status, surviving a mean of 5 months as compared to a mean of 17.5 months in those who never became hypercalcemic. The six HTLV-I-positive lymphomas that underwent cell typing were all primarily OKT4 positive, whereas two HTLV-I antibody-negative cases that were typed were B-cell lymphomas.
作为牙买加人类嗜T淋巴细胞病毒1型（HTLV-I）相关恶性肿瘤流行病学研究的一部分，作者评估了26例非霍奇金淋巴瘤患者的恶性细胞中是否存在整合的HTLV-I前病毒。26例患者中有15例存在整合的前病毒。这15例患者的HTLV-I抗体也均为阳性。11例患者没有整合的前病毒，且这11例患者的抗体均为阴性。所有抗体阳性病例的疾病均在成年期发病（年龄范围为21至57岁），而抗体阴性病例的年龄范围较广（4至66岁）。前病毒阳性患者比阴性患者更常见的临床特征包括白血病期、皮肤受累和高钙血症，这些都是HTLV-I相关成人T细胞白血病/淋巴瘤（ATLL）中常见的特征。病毒阳性和病毒阴性病例在皮肤受累、循环恶性细胞、肝功能检查异常或这四个特征中出现两个或更多特征的情况在统计学上有显著差异。尽管阳性病例的生存期（6个月）短于阴性病例（9个月），但差异无统计学意义。生存的唯一显著决定因素是高钙血症，在病程中出现高钙血症的患者，无论其HTLV-I状态如何，平均生存期为5个月，而从未发生高钙血症的患者平均生存期为17.5个月。进行细胞分型的6例HTLV-I阳性淋巴瘤均主要为OKT4阳性，而进行分型的2例HTLV-I抗体阴性病例为B细胞淋巴瘤。
