EB病毒感染与早期鼻型结外NK/T细胞淋巴瘤患者疗效及预后的关系

许恬; 杨露; 袁芳琴; 何侠; 尹丽

doi:10.3971/j.issn.1000-8578.2021.21.0216

EB病毒感染与早期鼻型结外NK/T细胞淋巴瘤患者疗效及预后的关系

Relation Between EB Virus Infection and Curative Effect, Prognosis of Patients with Early-stage Extranodal Nasal-type NK/T-cell Lymphoma

摘要

摘要:
目的探讨早期结外鼻型NK/T细胞淋巴瘤（ENKTCL）患者治疗前EBV DNA载量、治疗前血清EA-IgA及VCA-IgA抗体水平与临床特征、治疗反应及预后的关系。
方法分析78例早期结外鼻型NK/T细胞淋巴瘤患者的临床特征及影响预后的因素。
结果治疗前EBV DNA、VCA-IgA、EA-IgA阳性率分别为43.6%、20.5%、14.1%。EBV DNA与Ann Arbor分期、原发部位、PTI、治疗后未获得CR显著相关（均P < 0.05）。VCA-IgA、EA-IgA滴度分别与EBV DNA、治疗后未获得CR显著相关（均P < 0.05）。多因素分析发现年龄、EBV DNA、治疗后未获得CR为早期ENKTCL患者OS的独立预后因素（均P < 0.05）；年龄、EBV DNA、原发鼻腔外上呼吸消化道、治疗后未获得CR（均P < 0.05）则为早期ENKTCL患者PFS的独立预后因素。
结论治疗前EBV DNA阳性与较晚的Ann Arbor分期、PTI、原发鼻腔外上呼吸消化道、治疗反应差有关。EA-IgA、VCA-IgA水平升高与EBV DNA阳性、治疗反应差有关。治疗前EBV DNA可用于ENKTCL的风险分层及预后预测，而EA-IgA、VCA-IgA对于ENKTCL的预后指导作用有限。

Abstract:
Objective To explore the correlation of pretreatment EBV DNA load, EBV EA-IgA and VCA-IgA antibodies levels with the clinical characteristics, curative effect and prognosis of the patients with early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTCL).
Methods We analyzed the clinical features and prognostic factors of 78 ENKTCL patients.
Results Positive rates of pretreatment EBV DNA, VCA-IgA and EA-IgA were 43.6%, 20.5% and 14.1%, respectively. EBV DNA was significantly associated with Ann Arbor stage, primary site, PTI and non-CR (all P < 0.05). VCA-IgA and EA-IgA were related to positive EBV DNA and non-CR (all P < 0.05). Multivariate analysis showed that age, EBV DNA and non-CR were independent prognostic factors for OS (all P < 0.05); age, EBV DNA, primary site and non-CR were independent prognostic factors for PFS (all P < 0.05).
Conclusion The pretreatment positive EBV DNA is related to advanced Ann Arbor stage, PTI, primary extra-nasal subtypes of upper aerodigestive tract and poor response to treatment. The elevated levels of EA-IgA and VCA-IgA are related to positive EBV DNA and poor response to treatment. Pretreatment EBV DNA could be used for risk stratification and prognosis prediction of ENKTCL, while EA-IgA and VCA-IgA play limited role in guiding the prognosis of ENKTCL.

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