EB病毒诱发人B细胞淋巴瘤的分子病理特性

EB病毒 (EBV ,Epstein Barrvirus)与人类多种肿瘤有关 ,尤其是与鼻咽癌和淋巴瘤的关系密切。为此研究了EB病毒在huPBL SCID嵌合体小鼠体内诱发人B细胞淋巴瘤的分子特性及肿瘤发生机制。从健康成人外周血分离出淋巴细胞 ,将之移植到SCID小鼠腹腔内 ,实验感染EBV ,观察肿瘤的形成 ;采用单向免疫扩散法连续监测小鼠血清中人IgG的含量。分别用PCR方法检测肿瘤组织中是否存在人Alu序列 ,原位杂交检测肿瘤组织中EB病毒小RNA分子EBER 1;免疫组织化学方法检测人白细胞分化抗原 (CD4 5、CD2 0、CD4 5RO、CD3) ,病毒基因(LMP1、EBNA2、BZLF1)的表达 ,以及细胞瘤基因蛋白 (p5 3、C myc、Bcl 2、Bax)在诱发肿瘤中的表达情况。结果发现 ,实验中 34只感染EBV的huPBL SCID小鼠有 2 4只诱发出肿瘤 ,根据病理形态学特征、Alu PCR和免疫标志均证实诱发瘤是人源性B淋巴细胞肿瘤。原位分子杂交显示肿瘤细胞核内存在EBER 1,少数瘤细胞表达EB病毒BZLF1蛋白阳性 ,部分瘤细胞表达LMP1和EBNA2蛋白阳性。连续监测 12只huPBL SCID小鼠血清中人IgG含量 ,发现IgG水平随诱瘤时间延长和肿瘤生长有逐渐增高趋势。免疫组化显示诱发的 2 4例淋巴瘤组织p5 3、C myc、Bcl 2和Bax蛋白表达阳性率分别为 83.33%、10 0 %、95 .83%、91.6 7%。结果     

EB病毒即刻早期BRLF1基因在淋巴瘤组织中多态性研究

目的：EB病毒（Epstein．Barrvirus,EBV）感染宿主细胞包括潜伏期和裂解期,它的即刻早期基因BRLFl编码产物Rta蛋白是EBV从潜伏期到裂解期的关键性调节因子。目前,Rta蛋白已成为治疗EBV相关肿瘤的靶蛋白,但有关BRLFl基因在EBV阳性淋巴瘤中的研究甚少,本研究旨在明确EB病毒即刻早期基因BRLFl在EB病毒阳性淋巴瘤组织中的变异规律,探讨其变异意义。方法：原位杂交筛选EB病毒阳性淋巴瘤（BL）,提取EB病毒DNA。PCR结合DNA测序检测EBV阳性淋巴瘤中BRLFl基因多态性,应用DNAStar软件对序列进行对比分析。结果：共筛选出27例EBV阳性淋巴瘤标本,在27例BL阳性标本中成功扩增BRLFl基因,与B95—8标准序列比对分析,共发现20处无义突变和19处有义突变。8例属于BR1-A亚型,18例属于BRl—C亚型,1例属于BRl-E亚型,其中以BRl-A亚型和BRl-C亚型最为常见,分别为29．6％（8／27）、66．7％（18／27）。与EBVaGC、NPC和1W相比,4种人群BRLFl亚型的分布不同,其中BRl-A亚型更多出现在健康人群中,BRl-C亚型更多出现在NPC和BL中。在Rta蛋白功能区中,二聚体区域呈高度保守,在DNA结合区域和反式激活区域均检测出序列突变,16种CTL抗原表位中,只有NAA、QKE和ERP表位发生改变,且NAA和QKE在健康人群中突变率较高。结论：山东地区EB病毒阳性淋巴瘤BRLFl基因变异类型主要为BRl-A亚型和BRl-C亚型。BRl-C亚型可能与BL相关,发生在Rta蛋白DNA结合区域和反式激活区域的突变可能对其功能产生影响,多数CTL表位序列保守提示BRLFl可以用作EBV相关淋巴瘤免疫治疗的靶基因。     

Epstein-Barr病毒相关T/NK细胞淋巴瘤与B细胞淋巴瘤的临床分析

Epstein-Barr病毒(Epstein-Barr virus,EBV)是可导致人类感染的淋巴滤泡病毒,感染非常普遍。本研究通过对2013年1月-2016年12月于复旦大学附属华东医院就诊并确诊为淋巴瘤且伴有EBV感染的49例患者的临床资料进行回顾性分析,探讨EBV相关淋巴瘤患者的临床特点及生存情况。结果显示,49例EBV相关淋巴瘤患者中,18例为B细胞淋巴瘤,31例为T/NK细胞淋巴瘤。EBV相关B细胞淋巴瘤与T/NK细胞淋巴瘤患者之间白细胞、血小板、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸脱氢酶、铁蛋白、纤维蛋白原、红细胞沉降率、C反应蛋白的差异有统计学意义(P<0.05)。中位随访5.0个月,49例患者的1个月、6个月、1年、3年生存率分别为 84.4%、59.8%、53.2%、40.3%。结果表明,与EBV相关B细胞淋巴瘤患者相比,EBV相关T/NK细胞淋巴瘤患者的肝功能损伤严重,更易合并噬血细胞综合征,生存期更短,但生存期差异无统计学意义。     

EBV与非霍奇金淋巴瘤的相关性研究

目的探讨EBV与非霍奇金淋巴瘤的相关性。方法采用免疫荧光法检测62例非霍奇金淋巴瘤患者外周血血清中EBV-VCA-IGA,进而探讨EBV感染与非霍奇金淋巴瘤的相关性。结果92例非霍奇金淋巴瘤患者EBV-VCA-IGA阳性率为36%,B细胞来源非霍奇金淋巴瘤患者EBV-VCA-IGA阳性率为34%,T细胞来源非霍奇金淋巴瘤患者EBV-VCA-IGA阳性率为38%。结论EBV与非霍奇金淋巴瘤关系密切,监测EBV感染状况,对非霍奇金淋巴瘤的早期诊断及预后判断具有重要意义。     

EB病毒诱导胸腺恶性T细胞淋巴瘤的研究

为研究EB病毒在恶性T细胞淋巴瘤发生中的作用,将EB病毒感染的人胚胸腺细胞移植于Scid鼠皮下,于移植后第3日起在移植处对侧皮下注射TPA50ng／只,每周1次。于移植后第4周起,移植处皮下有结节状隆起形成,并逐渐增大。于6－15周内行病理学检查和免疫组织化学染色,证实为T细胞淋巴瘤8例。其中实验组胸腺细胞＋EBV的成瘤率为25％（1／4）,胸腺细胞＋EBV＋TPA组的成瘤率为53.8%（7／13）,对照组胸腺细胞＋TPA的成瘤率为0（0／5）。PCR和 闰杂交在诱导肿瘤可可检测到EB病毒的基因EBERs、LMP1和BARF1,并有病毒基因LMP1蛋白编码产物的表达。EB病毒可感染人胚胸腺细胞,并使其发生恶性转化,EB病毒可能在恶性T细胞淋巴瘤的发生中起病因作用。     

EBER原位杂交结合CK免疫组织化学双染在诊断鼻咽癌中的应用价值

目的探讨全自动免疫组织化学仪行EB病毒早期RNA(Epstein-Barr virus early RNA,EBER)与细胞角蛋白(cytokeratin,CK)双染在鼻咽癌诊断中的应用价值。方法收集我院2018年1月至2019年12月鼻咽活检组织60例,根据诊断结果进行分组,A组为鼻咽非角化型未分化性癌30例,B组为上皮性病变30例。在VENTANA全自动免疫组织化学仪平台上分别对这两组病变进行CK免疫组织化学染色、EBER原位杂交、EBER原位杂交结合CK免疫组织化学(EBERCK)双染标记,其中双染再分为是否复染苏木素,比较染色情况。结果免疫组织化学CK单染A、B组均可见阳性细胞;原位杂交EBER单染A组鼻咽癌细胞阳性,B组表达呈阴性;EBER-CK双染A组鼻咽癌细胞呈双阳性,B组病变细胞呈CK阳性、EBER呈阴性,未见双阳性表达;EBER-CK双染复染苏木素后的表达与未复染苏木素的表达相同,但对比差,不易观察。结论全自动免疫组织化学仪行EBER-CK双染有助于鼻咽癌组织学诊断,不复染苏木素效果更佳,值得推广。     

EB病毒诱导的胸腺恶性T细胞淋巴瘤细胞体外长期培养研究

建立含有EB病毒的T细胞淋巴瘤细胞系,为探讨EB病毒的致瘤机理,研究EB病毒在T细胞淋巴瘤发生过程中的作用提供手段.在TPA协同EB病毒诱导胸腺恶性T细胞淋巴瘤动物模型的基础上,联合应用IL-2,将诱导的肿瘤组织进行体外细胞培养,成功地分离获得一株在体外长期存活的淋巴细胞TET.T细胞亚群分类实验证实TET细胞为CD4阳性的T淋巴细胞,PCR和原位杂交可检测到EB病毒的EBERs、LMP1和BARF1,并有LMP1蛋白的表达.TET细胞的获得,有望在体外建立转化细胞系,为体外研究EB病毒的致瘤机理及防治提供理想的实验材料.     

EB病毒侵入宿主细胞机制的研究进展

EB病毒(Epstein-barr virus,EBV),与多种人类疾病尤其是恶性肿瘤相关,包括单核细胞增多症、伯基特淋巴瘤和鼻咽癌等,其进入宿主细胞的机制仍是研究的热点。经过多年的研究,已经确定了EBV侵入宿主细胞时的部分关键蛋白以及不同的模式。病毒包膜糖蛋白gp350/220(EBV glycoprotein 350/220)与B淋巴细胞表面受体CR2(Complement Receptor type 2)的相互作用以及其他病毒糖蛋白如gp42(EBV glycoprotein 42)、gB(EBV glycoprotein B)、gH(EBV glycoprotein H)和gL(EBV glycoprotein L)的相互作用,使得EBV能够有效侵入B淋巴细胞。由于绝大多数上皮细胞缺少CR2受体,病毒侵入上皮细胞的机制要比侵入B淋巴细胞复杂得多。主要有三种EBV进入上皮细胞的模式:①EBV通过感染的B淋巴细胞或郎罕氏细胞直接接触上皮细胞,"转移感染"进入上皮细胞;②EBV利用自身的相关蛋白与宿主相应的受体蛋白相结合后,通过膜的融合或内吞作用,感染上皮细胞;③感染EBV的上皮细胞经基底膜将病毒颗粒传递给邻近的细胞。本篇综述将介绍近年来在EBV进入B淋巴细胞与上皮细胞的相关机制的研究进展。     

EB病毒感染与胃癌患者临床病理特征相关性的Meta分析

EB病毒(EPstein-Barr virus, EBV)感染与多种恶性肿瘤的发生相关. 大约10%的胃癌组织细胞中可以检测到EB病毒编码的小RNA(EBERs), 表明EBV感染与部分胃癌的发生相关. 为研究EBV感染与胃癌临床病理特征的相关性, 本研究汇总了EBV相关胃癌的研究论文, 对采用原位杂交方法检测EBV的22篇论文进行了Meta分析. 22篇入选的论文中收集的胃癌病例5475例, 检测到EBV阳性病例411例, EBV阳性率为7.5%. 在EBV阳性胃癌中, 男性检出率为11.1%, 女性检出率为3.0%, 男性检出率相当于女性检出率3倍多; EBV阳性胃癌与阴性胃癌相比具有较少的淋巴结转移; EBV阳性胃癌与癌组织发生部位相关, 并且残胃癌中EBV感染率较高. 依据组织学分型, EBV阳性胃癌弥漫型为8.1%, 肠型为8.0%. 统计分析显示, EBV感染与组织学分型无显著相关性(P＞0.05); 被检标本类型包括存档蜡块和新鲜手术切除组织标本: EBV阳性率分别为7.9%, 6.5%. 统计分析表明, EBV相关胃癌与标本类型无显著相关性(P＞0.05); 在地域分布方面, EBV阳性胃癌检出率美洲为9.4%, 亚洲为6.1%, 欧洲为9.1%, 统计分析显示, EBV相关胃癌与地域分布显著相关(P＜0.05). Meta分析表明, EBV感染仅发生在胃癌组织细胞中, 并且与患者性别、淋巴结转移、肿瘤组织发生部位及地域分布显著相关(P＜0.05), 与患者肿瘤组织学分型、标本类型无显著相关性(P＞0.05). 结果提示, EBV阳性胃癌具有独特的临床病理学特征.     

EB病毒血清学试验进展

<正>序言 生命早期的婴儿常常发生EB病毒(EBV)感染。这些感染通常是无症状的或者伴轻度非特异性表现。EBV感染在世界发达地区和当年轻成人原发或初期感染时往往表现为传染性单核细胞增多症(IM)。此病毒最初是在伯基特氏淋巴瘤持续感染的淋巴细胞系中发现的。EBV感染首先是B淋巴细胞。B淋巴细胞在EBV原发感染后继续庇护该病毒染色体组,并保持其潜伏感染,很可     

原发性小肠淋巴瘤6例临床分析并文献复习

目的:探讨原发性小肠淋巴瘤临床特点,诊断及治疗方法。方法:对1997-2012年确诊的6例原发性小肠淋巴瘤患者的临床资料进行临床分析,总结其临床特点,同时复习相关文献。结果:隐性失血、脐周隐痛、腹部肿物、隐匿消瘦是原发性小肠淋巴瘤的最常见表现,而以全身症状为主的很少。推进式小肠镜及胶囊内镜的应用对该病诊断有重要价值,但阳性率较低。MSCT和MRE对本病的诊断有重要辅助作用。本组患者病理结果均为非霍奇金淋巴瘤,其中B细胞型4例,T细胞型2例,4例发生淋巴转移。6例患者中4例行手术切除治疗,2例行单纯化疗,2例死亡。结论:选择有效的检查手段,可提高小肠肿瘤的术前诊断,降低其误诊误治的发生率。手术切除是治疗该疾病的主要手段,采用手术后配合化疗及放疗的综合治疗可提高患者的生存率。     

原发性小肠淋巴瘤6例临床分析并文献复习

目的：探讨原发性小肠淋巴瘤临床特点,诊断及治疗方法。方法：对1997—2012年确诊的6例原发性小肠淋巴瘤患者的临床资料进行临床分析,总结其临床特点,同时复习相关文献。结果：隐性失血、脐周隐痛、腹部肿物、隐匿消瘦是原发性小肠淋巴瘤的最常见表现,而以全身症状为主的很少。推进式小肠镜及胶囊内镜的应用对该病诊断有重要价值,但阳性率较低。MSCT和MRE对本病的诊断有重要辅助作用。本组患者病理结果均为非霍奇金淋巴瘤,其中B细胞型4例,T细胞型2例,4例发生淋巴转移。6例患者中4例行手术切除治疗,2例行单纯化疗,2例死亡。结论：选择有效的检查手段,可提高小肠肿瘤的术前诊断,降低其误诊误治的发生率。手术切除是治疗该疾病的主要手段,采用手术后配合化疗及放疗的综合治疗可提高患者的生存率。     

Analysis of Epstein-Barr virus strains and variants in classical Hodgkin's lymphoma by laser microdissection

Epstein-Barr virus (EBV) seems to have an etiological role in the pathogenesis of classical Hodgkin's lymphoma (cHL). Studies of whole tissue DNA by polymerase-chain reaction (PCR) have shown a considerable number of cHL cases with co-infections by different EBV strains and variants, which apparently contradict the clonality of EBV in cHL previously demonstrated by Southern blot analysis. Due to the paucity of HRS cells in HL tissues, studies on single cell DNA are necessary to identify the specific cellular location (HRS cells and/or bystander B lymphocytes) of the EBV strains and variants present in tissue specimens. In the current study, the presence of EBV was determined by PCR of the 3' end of the LMP-1 gene and EBNA-3C gene in whole tissue and, consecutively, in isolated cells from 26 cases of cHL: 10 HIV-positive and 16 sporadic cHL cases. EBV EBERs were present in all but 2 sporadic cHL cases, which were used as negative controls. At isolated cell level, EBNA-3C gene PCR was more sensitive. Indeed, from the cHL cases in which dual-infection was present, it was observed that, in most of them, HRS cells were infected by type 1 virus, and B lymphocytes were co-infected by both types, which points towards EBV infection occurring early in cHL development. Moreover, the finding of 2 cases with dual-infection in HRS may suggest that, in a small percentage of cHL cases, HRS cells derive from different neoplastic clones, or that HRS cells are superinfected by other viral types after the establishment of the neoplastic clone.     

双歧杆菌对免疫抑制小鼠白色念珠菌感染的保护作用

为探讨双歧杆菌对白色念珠菌感染的保护作用,作者采用环磷酰胺腹腔注射方法复制了免疫抑制小鼠模型,研究白色念珠菌感染前后两歧双歧杆菌灌饲的保护作用。结果表明：白色念珠菌感染前灌饲两歧双歧杆菌能有效地抑制白色念珠菌在小鼠肠道中的定植,并且保护肠粘膜的完整性。对其机理的研究认为,两歧双歧杆菌可能是通过调整肠道菌群平衡、增加肠道中生理菌群的数量、降低肠道ｐＨ值、以及产生抗菌物质等途径发挥保护作用     

CD4+ T-cell effectors inhibit Epstein-Barr virus-induced B-cell proliferation

In immunodeficient hosts, Epstein-Barr virus (EBV) often induces extensive B-cell lymphoproliferative disease and lymphoma. Without effective in vitro immune surveillance, B cells infected by the virus readily form immortalized cell lines. In the regression assay, memory T cells inhibit the formation of foci of EBV-transformed B cells that follows recent in vitro infection by EBV. No one has yet addressed which T cell regulates the early proliferative phase of B cells newly infected by EBV. Using new quantitative methods, we analyzed T-cell surveillance of EBV-mediated B-cell proliferation. We found that CD4+ T cells play a significant role in limiting proliferation of newly infected, activated CD23+ B cells. In the absence of T cells, EBV-infected CD23+ B cells divided rapidly during the first 3 weeks after infection. Removal of CD4+ but not CD8+ T cells also abrogated immune control. Purified CD4+ T cells eliminated outgrowth when added to EBV-infected B cells. Thus, unlike the killing of EBV-infected lymphoblastoid cell lines, in which CD8+ cytolytic T cells play an essential role, prevention of early-phase EBV-induced B-cell proliferation requires CD4+ effector T cells.     

Interferon production potentials of various human lymphoblastoid cell lines

A number of human lymphoblastoid cells were examined concerning their ability to produce spontaneously liberated and virus-induced interferon (IFN). It was found that, in addition to B cells, various T and nonT-nonB lymphoblastoid cells responded well to Sendai virus infection to form IFN, the characterization of which has been recently reported (20). One B lymphoblastoid cell line from an infectious mononucleosis (IM) patient produced a large amount of IFN-alpha and might become an alternative source of IFN production. Among 68 cell lines examined, 35 cell lines liberated 10 U/ml or more of IFN spontaneously in culture fluid. The presence of Epstein-Barr virus (EBV) genome or its activation appears to have no correlation with the spontaneous liberation of IFN. Spontaneously produced IFN from three cell lines was characterized as IFN-alpha. Comparatively higher amounts of IFN were produced in cells from IM patients than those from Burkitt's lymphoma cases or healthy adults. Spontaneously produced IFN was detected more easily in cells transformed by EBV alone than in those transformed by EBV and a tumor promoter, TPA.     

Small intestinal presentation of nodular lymphocyte-predominant Hodgkin lymphoma with T cell/histiocyte-rich B cell lymphoma-like areas-with review of literature on extranodal presentation of this disease

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), accounts for ～5% of all cases of Hodgkin lymphoma and is characterized by involvement of the peripheral lymph nodes. NLPHL occurs in young adults and is associated with frequent relapses. In 3% to 7% of cases, NLPHL progresses to a diffuse large B cell lymphoma. Furthermore, a proportion of NLPHL also have areas with features of T cell/histiocyte-rich large B cell lymphoma (THRLBCL), either at presentation or on follow-up. Here, we describe a 32-year-old man who presented to the emergency department with small bowel perforation. The resected small bowel showed full-thickness mural ulceration and involvement by a lymphoma with features of NLPHL that also had areas resembling THRLBCL. The patient had axillary lymphadenopathy, biopsy of which showed NLPHL with focal THRLBCL-like areas. Such a lymphoma presenting as small intestinal lesion/perforation has not been reported in the literature before. We take this opportunity to review the literature on extranodal presentations of NLPHL and discuss the natural history of this disease.