Nohtani Mahdi, Vrzalikova Katerina, Ibrahim Maha, Powell Judith E, Fennell Éanna, Morgan Susan, Grundy Richard, McCarthy Keith, Dewberry Sarah, Bouchal Jan, Bouchalova Katerina, Kearns Pamela, Murray Paul G
Bernal Institute, University of Limerick, V94 T9PX Limerick, Ireland.
School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland.
Cancers (Basel). 2022 Sep 1;14(17):4297. doi: 10.3390/cancers14174297.
In this study, we have re-evaluated how EBV status influences clinical outcome. To accomplish this, we performed a literature review of all studies that have reported the effect of EBV status on patient outcome and also explored the effect of EBV positivity on outcome in a clinical trial of children with cHL from the UK. Our literature review revealed that almost all studies of older adults/elderly patients have reported an adverse effect of an EBV-positive status on outcome. In younger adults with cHL, EBV-positive status was either associated with a moderate beneficial effect or no effect, and the results in children and adolescents were conflicting. Our own analysis of a series of 166 children with cHL revealed no difference in overall survival between EBV-positive and EBV-negative groups ( = 0.942, log rank test). However, EBV-positive subjects had significantly longer event-free survival ( = 0.0026). Positive latent membrane protein 1 (LMP1) status was associated with a significantly lower risk of treatment failure in a Cox regression model (HR = 0.21, = 0.005). In models that controlled for age, gender, and stage, EBV status had a similar effect size and statistical significance. This study highlights the age-related impact of EBV status on outcome in cHL patients and suggests different pathogenic effects of EBV at different stages of life.
在本研究中，我们重新评估了EBV状态如何影响临床结局。为实现这一目标，我们对所有报道过EBV状态对患者结局影响的研究进行了文献综述，并在一项来自英国的儿童cHL临床试验中探讨了EBV阳性对结局的影响。我们的文献综述显示，几乎所有关于老年成人/老年患者的研究都报告了EBV阳性状态对结局有不利影响。在年轻的cHL成人患者中，EBV阳性状态要么与适度的有益影响相关，要么无影响，而儿童和青少年的结果则相互矛盾。我们对166例儿童cHL患者的系列分析显示，EBV阳性组和EBV阴性组的总生存率无差异（P = 0.942，对数秩检验）。然而，EBV阳性受试者的无事件生存期显著更长（P = 0.0026）。在Cox回归模型中，潜伏膜蛋白1（LMP1）阳性状态与治疗失败风险显著降低相关（HR = 0.21，P = 0.005）。在控制了年龄、性别和分期的模型中，EBV状态具有相似的效应大小和统计学意义。本研究强调了EBV状态对cHL患者结局的年龄相关影响，并提示EBV在生命不同阶段具有不同的致病作用。
