| Background and purposeExtranodal natural killer/T-cell lymphoma, nasal type is a rare type of nonhodgkin’s lymphoma(NHL), accounts for about 5%~18% of NHL, located in the first chart of T-cell lymphoma. Incidence of China is much higher than the western countries, mainly in the nasal cavity and nasal side area, the disease is highly invasive progress, is not sensitive to chemotherapy and survival period is short, with poor prognosis. Suzuki reported that EB virus exists in almost all NK/T cell lymphoma cells, and has nothing to do with race and parts, which prompt that EBV maybe an important factor in ENKTL development. Usually available in situ hybridization technique in tumor cells to detect the encoding of small mRNA(EBER), but there are still a few patients EBER to express negative, there is no one on this part of the clinical features and prognostic factors were studied. This research detected the EBER expression with in situ hybridization in patients with NK/T cell lymphoma,nasal type specimens, analyze its characteristics and the correlation with the prognosis.Datas and MethodsCollect the 1st affiliated hospital of zhengzhou university between August 2011 and October 2011 by HE staining and immunohistochemical diagnosis of ENKTL cases 326 cases, lymphoma pathologic by two senior experts to read, consistent with the WHO classification of tumor lymphatic hematopoietic system standard in 2008,using in situ hybridization technique to detect the expression of EBER, 8 patients with negatie EBER were retrospectively analyzed the clinical features and prognosis related factors, then compared with EBER positive patients.Statistical MethodsTo adopt SPSS21.0 statistical software for statistical processing. EBER negative and EBER positive patients survival analysis with Kaplan Meier survival analysis, the survival rates of two groups of patients compared with Log-rank test, Multi-factor survival analysis by using the COX proportional hazards regression model method, in order to a=0.05 for inspection standard.Results1.The EBER expression in ENKTL: in 326 ENKTL cases, EBER express positive 318 cases, negative express in 8 patients, EBV positive rate was 2.45%, EBV negative rate was 2.45%.2.EBER negative patients’ clinical data: 8 cases of EBER express negative patients, 6 cases of male and female in 2 cases, the sex ratio for 6:2, Age distribution at 21 to 70, the median age of 45.25± 14.76 years old, 7 cases occurred in nasal cavity, 1 case of primary esophageal. All patients were in stage I-II, no local lymph node enlargement, three of the patients with B symptoms, 1 case of LDH increased,prognostic index 0 in 5 cases, 1 in 2 cases, 2 points in 1 case, a total of 3 patients has a higher EBV-DNA copy number before treatment.3.Survival: as of December 1, 2015(follow-up time of 1.5-48 months), 3 cases of EBER negative patients live in, 5 cases died. A total of 54 patients can trace back to the pretreatment EBV-DNA copy number, in these patients, 41 patients was alive,13 cases died. The median survival time for 17 months, it is unable to estimate the median survival of EBER positive patients. The 2-years PFS of EBER negative andEBER positive were 40.0% and 77.3%, respectively( Log-rank chi-square test=3.951,P =0.047 <0.05). The 2-years OS were 41.7%和 79.3%,respectively( Log-rank chi-square test=4.574,P =0.032 <0.05). The survival curves’ difference were statistically significant.4.Prognostic factors analysis: LDH has the relevant with EBER negative ENKTL patients death(P = 0.008 < 0.05), and the treatment of other factors such as former plasma EBV DNA copy number has nothing to do with the death(P > 0.05).ConclusionEBER express negative extranodal NK/T cell lymphoma has a low incidence,occurs in middle-aged men, mostly early cases of nasal cavity, prognosis is poor compared with EBER positive patients, elevated LDH may be its prognosis factors. |
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