Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.
J Oral Pathol Med. 2018 Nov;47(10):915-922. doi: 10.1111/jop.12753. Epub 2018 Jul 5.
Plasmablastic lymphoma (PBL) is a high-grade lymphoma that often affects the oral cavity of HIV-positive patients; however, its prognostic determinants remain unknown.
To integrate the available data on oral PBL to determine its clinicopathological features and to identify potential prognostic factors.
An electronic systematic review was performed using multiple databases with a specific search strategy in February 2018. Inclusion criteria comprised cases diagnosed as PBL affecting the oral cavity and gnathic bones with sufficient data to confirm the diagnoses.
A total of 70 publications were included, representing 153 cases. Oral PBL predominantly affected HIV-positive males (76.4%). EBV was observed in 63.4% of the cases. The gingiva was the most involved site and the lesion usually presented as an asymptomatic swelling. Most cases were classified as stage I (21.6%), and chemotherapy alone was applied in 28.8% of the cases. There was a significant association between HIV and EBV infections, and cases affecting HIV-negative patients were more common in older individuals. Cumulative survival of the patients achieved 42.4% and 33.5% after 2 and 5 years, respectively. Although there were no statistically significant clinicopathological parameters in the univariate analysis, the multivariate Cox regression model demonstrated that EBV-positive status, presence of B-symptoms, and chemotherapy alone were independent prognostic determinants of a poor prognosis.
Oral PBL is an aggressive neoplasm with low survival rates, which is influenced by the presence of EBV, presence of B-symptoms, and with the use of chemotherapy only.
浆母细胞淋巴瘤（PBL）是一种高级别的淋巴瘤，常发生于 HIV 阳性患者的口腔；然而，其预后决定因素仍不清楚。
整合关于口腔 PBL 的现有数据，以确定其临床病理特征，并确定潜在的预后因素。
2018 年 2 月，我们使用多个数据库进行了电子系统综述，并采用特定的搜索策略。纳入标准包括诊断为影响口腔和颌骨的 PBL 病例，且有足够的数据可明确诊断。
共纳入 70 篇文献，代表了 153 例病例。口腔 PBL 主要发生于 HIV 阳性的男性（76.4%）。在 63.4%的病例中观察到 EBV。牙龈是最常受累的部位，病变通常表现为无症状性肿胀。大多数病例为Ⅰ期（21.6%），28.8%的病例仅接受化疗。HIV 和 EBV 感染之间存在显著关联，且影响 HIV 阴性患者的病例在老年人中更为常见。患者的累积生存率分别为 2 年时的 42.4%和 5 年时的 33.5%。虽然在单因素分析中没有统计学意义的临床病理参数，但多因素 Cox 回归模型表明 EBV 阳性状态、B 症状存在和仅接受化疗是预后不良的独立预后因素。
口腔 PBL 是一种侵袭性很强的肿瘤，生存率较低，受 EBV 存在、B 症状存在以及仅接受化疗的影响。
