血浆中爱泼斯坦-巴尔病毒DNA在结外NK/T细胞淋巴瘤预后评估方面优于全血中的该病毒DNA 。
Superiority of Epstein-Barr Virus DNA in the Plasma Over Whole Blood for Prognostication of Extranodal NK/T Cell Lymphoma.
作者信息
Ha Joo Young, Cho Hyungwoo, Sung Heungsup, Jung Ah Ra, Lee Yoon Sei, Lee Sang-Wook, Ryu Jin-Sook, Chae Eun Jin, Kim Kyung Won, Huh Jooryung, Park Chan-Sik, Kim Dong-Joon, Kim Seon-Ok, Yoon Dok Hyun
机构信息
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Division of Hematology/Medical Oncology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
出版信息
Front Oncol. 2020 Nov 30;10:594692. doi: 10.3389/fonc.2020.594692. eCollection 2020.
BACKGROUND
Extranodal natural killer T cell lymphoma (ENKTL) is a rare subtype of non-Hodgkin lymphoma with invariable infection of lymphoma cells with Epstein-Barr virus (EBV), and the presence of EBV-DNA in the blood is a well-known prognosticator. However, there is no consensus on which blood compartment is more optimal for predicting survival outcomes.
METHODS
We analyzed 60 patients who were newly diagnosed with ENKTL from a prospectively collected database. EBV-DNA was measured in the whole-blood (WB) and plasma at the time of diagnosis and after treatment completion.
RESULTS
EBV-DNA was detected in pre-treatment WB and plasma in 37 (61.7%) and 23 (38.3%) patients, respectively. The presence of pre-treatment plasma EBV-DNA was significantly associated with advanced stage while presence of WB EBV-DNA did not. Positivity of pre-treatment plasma-EBV, but not WB EBV-DNA, was independently associated with poor PFS (HR, 4.22;95% CI, 1.79-9.97; =0.001) and OS (HR, 8.38; 95% CI, 3.03-23.19; <0.001) in the multivariate analysis. After treatment completion, positivity of plasma-EBV was independently associated with poor PFS (HR, 9.41; 95% CI, 2.27-39.02; =0.002) and OS (HR, 32.38; 95% CI, 3.25-322.56; =0.003), whereas no significant association was observed between WB-EBV status and survival outcomes.
CONCLUSIONS
Our results suggest that EBV-DNA in the plasma has better prognostic values than WB in patients with ENKTL.
背景
结外自然杀伤T细胞淋巴瘤（ENKTL）是非霍奇金淋巴瘤的一种罕见亚型，淋巴瘤细胞始终感染爱泼斯坦-巴尔病毒（EBV），血液中EBV-DNA的存在是一个众所周知的预后指标。然而，对于哪个血液成分更适合预测生存结果尚无共识。
方法
我们分析了前瞻性收集数据库中60例新诊断为ENKTL的患者。在诊断时和治疗完成后，对全血（WB）和血浆中的EBV-DNA进行测量。
结果
分别在37例（61.7%）和23例（38.3%）患者的治疗前全血和血浆中检测到EBV-DNA。治疗前血浆EBV-DNA的存在与晚期显著相关而全血EBV-DNA则不然。多因素分析中，治疗前血浆-EBV阳性而非全血EBV-DNA与较差的无进展生存期（HR，4.22；95%CI，1.79-9.97；P=0.001）和总生存期（HR，8.38；95%CI，3.03-23.19；P<0.001）独立相关。治疗完成后血浆-EBV阳性与较差的无进展生存期（HR，9.41；95%CI，2.27-39.02；P=0.002）和总生存期（HR，32.38；95%CI，3.25-322.56；P=0.003）独立相关，而全血-EBV状态与生存结果之间未观察到显著关联。
结论
我们的结果表明，ENKTL患者血浆中的EBV-DNA比全血具有更好的预后价值。
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