Research On The Relationship Between EB Virus And Curative Effect In Extranodal Natural Killer/T-Cell Lymphoma

Background and purposeExtranodal natural killer/T-cell lymphoma,nasal type is a rare type of nonhodgkin’s lymphoma(NHL),accounts for about 2%~10% of NHL.The incidence of this disease has obvious regional and racial susceptibility,it occurs frequently in Asia and South America,particularly in China,South Korea and Japan,while,it has rare incidence in Western Europe and North America.The most malignant cells of Extranodal NK/T cell lymphoma derived from mature NK cells,only a fraction of them derived from NK-like T cells,therefore,this type of lymphoma called as NK/T cell lymphoma.Most cases of Extranodal NK/T cell lymphoma predominantly occur in the nasal cavities and throat above parts,just a few cases of it occur beside of nasal cavities,such as the gastrointestinal tract,lung and skin.The pathology of Extranodal NK/T cell lymphoma is unique,it can be often seen blood vessels centered by pleomorphic lymphocyte infiltration,tumor cells can also invasion blood vessels, which in turn cause local tissue necrosis.Most Extranodal NK/T cell lymphoma can be evidenced of EB virus infection.It is confirmed that EB virus infection is closely related with the incidence of Extranodal NK/T cell lymphoma.In recent years,some foreign researches indicated that EB-DNA copies number is associated with Extranodal NK/T cell lymphoma, while,the domestic research is rare.In order to discuss the relationship between Extranodal NK/T cell lymphoma and EB-DNA copies number,our study adopt the quantitative real-time polymearase chain reaction(q RT-PCR)to monitor the EBV-DNA copies in the plasma,compare the difference of recent curative effect and long-term effect of patients with EBV positive and EBV negative. Datas and Methods109 patients with extranodal NK/T cell lymphoma,Diagnosed by Pathology and Immunohistochemistry,from January 2011 to April 2014 in department of the First Affiliated Hospital of Zhengzhou University. Using q RT-PCR detect EBV-DNA copies in the plasma for 109 patients with extranodal NK/T cell lymphoma.According to different EBV-DNA copies,it can be divided into groups EBV negative and EBV positive. Observe the recent efficacy and 2-year progression-free survival of patients with EBV negative and EBV positive,to evaluate the significant of EBV in the treatment of Extranodal NK/T cell lymphoma. Statistical MethodsUsing the SPSS 17.0 software for statistical analysis.Compare the objective response rate and disease control rate of different EBV-DNA copies by using χ2 test.By using the Kaplan-Meier method and Breslow test to compare the EBV-DNA copies with the 2-year progression-free survival.Make α=0.05 as inspection standard. Results1.Infection rate of EBV of patients with extranodal natural killer(NK)/T cell lymphoma:Of the 109 patients with extranodal NK/T cell lymphoma,there are 98 nasal NK/T cell lymphoma patients,the other 11 patients are extranasal type. The infection rate of EBV in nasal type is 53.1%(52/98),while,the infection rate in extranasal type is only 9.1%(1/11).2.Clinical data of patients with extranodal NK/T cell lymphoma were analyzed: of the 109 patients,53 patients with EBV positive,30 patients(56.6%,30/53)were in stage Ⅲ/Ⅳ,of the 56 patients with EBV negative,22 patients(39.3%,22/56)were stage Ⅲ/Ⅳ,the difference is statically significant(P<0.05).Of the 53 patients with EBV positive,there were 33 patients(62.3%,33/53)accompanied with B symptoms, which is significantly higher than 21 patients(37.5%,21/56)of EBV negative group(P<0.05).3.The relations of EBV infection and recent curative effect of patients with extranodal NK/T cell lymphoma:Of the 109 patients with extranodal NK/T cell lymphoma, the objective response rate and disease control rate of 53 patients with EBV positive were 41.5%(22/53) and 62.3%(33/53),the objective response rate and disease control rate of 56 patients with EBV negative were 60.7%(34/56)and 78.6%(44/56),the objective response rate has a significant difference(P<0.05),but did not affect disease control rate(P>0.05).4.The relations of EBV infection and 2-year progression-free survival of extranodal NK/T cell lymphoma:Of the 109 patients with extranodal NK/T cell lymphoma,the number of patients with the 2-year PFS is 59, there are 36 patients with EBV negative,and 23 patients with EBV positive.The patients with extranodal NK/T cell lymphoma,the 2-year PFS of EBV positive and negative were 13.3.5 months and 33.5 months,the median survival time were respectively 7.8 months and 12.5 months(P=0.01). ConclusionExtranodal NK/T cell lymphoma patients with EB virus positive,the objective response rate and 2-year progression-free survival was significant worse than EB virus negative patients,it was indicated that the detection of EB virus in plasma will be promise an important clinical indicator to evaluate the recent curative effect and the 2-year PFS of Extranodal NK/T cell lymphoma.