摘要目的 分析北方地区霍奇金淋巴瘤(HL)的临床病理特征,与EB病毒(EBV)感染的相关性.同时对不同方式检测EBV感染的结果进行比较.方法 收集确诊为HL 235例患者临床病理资料,复阅HE及免疫组织化学染色切片以核实诊断和分型,并进行临床病理特征分析.全部病例采用免疫组织化学染色法检测LMP1蛋白,其中101例经原位杂交法检测EBV编码的RNA(EBER)明确肿瘤细胞EBV感染情况.结果 患者发病年龄以21～35岁最常见,其次为56～60岁.男性135例,女性100例.淋巴结内原发者217例,淋巴结外原发者8例.除3例为结节性淋巴细胞为主型HL(NLPHL)外,其余均为经典型HL.235例均进行了CD30、CD20、CD3检测:227例肿瘤细胞表达CD30(阳性率96.6％),53例肿瘤细胞不同程度表达CD20(阳性率22.5％),仅有1例肿瘤细胞表达CD3(阳性率0.4％).224例进行CD15染色,117例(52.2％)阳性;进行PAX-5检测的213例中有160例(75.1％)的肿瘤细胞呈弱到中等表达.235例肿瘤细胞LMP1的免疫组织化学染色有72例(30.6％)阳性.而其中101例同时进行了原位杂交检测的病例中有40例(39.6％) EBER检测阳性,其中30例表达LMP1,而EBER原位杂交检测阴性病例中仅5例表达LMP1,两种方法比较差异无统计学意义(P=0.3),总体符合率达85.2％.结论 北方地区HL发病年龄呈“双峰”特征,男性略多,发病部位以结内原发为主.病理类型最常见的是结节硬化型和混合细胞型.免疫组织化学染色法检测LMP1更为经济易行,且与EBER原位杂交具有高度一致性和高总体符合率.

abstractsObjective To study the clinicopathologic features of Hodgkin lymphoma (HL) occurring in northern China,association with Epstein-Barr virus (EBV) infection and concordance between EBV protein immunohistochemistry (IHC) and in-situ hybridization (ISH).Methods Two hundred and thirty-five cases were collected and their HE and IHC slides were reviewed to confirm the diagnosis and sort of HLs.All cases were performed with IHC staining for LMP-1 protein and ISH of EBV-encoded RNAs (EBER) was done in 101 cases to detect the existence of EBV.Results The incidence peak was between age 25 and 35 years,followed by another peak between age 56 to 60 years.There were 135 males and 100 females.The tumor involved lymph nodes in 217 cases,and extranodal sites in 18 cases.There were 3 cases of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) and 232 cases of classical Hodgkin lymphoma.All tumors were stained for CD30,CD20,CD3.CD30 was expressed in 227 cases (96.6％),CD20 was expressed in 53 cases (22.5％) with different level of intensity.CD3 was expressed only in 1 case (0.4％).CD15 staining was performed in 224 cases and 117 (52.2％) cases were positive.PAX-5 were performed in 213 cases and 160 (75.1％) cases showed weak to moderate expressions.Two hundred and thirty-five cases were immunohistochemically stained with LMP1 and 72 (30.6％) cases were positive.Meanwhile,EBER ISH were applied in 101 cases,and 40 cases (39.6％) were found positive.LMP1 was expressed in 30 cases among those EBER-positive cases,while LMP1 was only detected in 5 cases of the EBER-negative cases.There was no statistically significantce between LMP1 IHC and EBER ISH by pared chi-square test (P =0.3),the overall concordance rate was 85.2％.Conclusions There was a bimodal age distribution in our group of HL cases from the northern part of China,with slight male predominance and mainly nodal involvement.Nodular sclerosis (NS) and mixed cellularity (MC) were major histologic subtypes.When it was compared with the EBER ISH method in detection EBV infection of HL,the more economical and convenient LMP1 IHC showed both high degree of consistency and overall concordance rate.