广州地区口腔鳞状细胞癌中EB病毒与人乳头状瘤病毒的感染及临床病理特征——以中山大学附属医院的标本为例

Epstein-Barr virus and human papillomavirus infections and clinicopathological characteristics in oral squamous cell carcinoma in Guangzhou: a study based on specimens from affiliated hospitals of Sun Yat-sen University

  • 摘要: 目的 探讨广州地区口腔鳞状细胞癌(OSCC)中EB病毒(EBV)、人乳头状瘤病毒(HPV)的感染及临床病理特征。方法 收集广州地区304例OSCC标本,其中123例来自中山大学附属第三医院(2014年1月至2024年12月),181例来自中山大学孙逸仙纪念医院(2017年1月至2018年12月)。采用聚合酶链反应(PCR)检测病毒DNA,原位杂交分析EBV编码小RNA(EBER)表达,免疫组织化学检测病毒相关蛋白并明确感染类型。结果 在304例OSCC标本中,26.3%(80/304)为EBV-PCR阳性,其中63.8%(51/80)确诊于TNM分期的Ⅰ/Ⅱ期,与阴性标本相比,肿瘤分期差异具有统计学意义(P = 0.042)。EBV-PCR阳性OSCC标本中,EBER阳性率为33.8%(27/80),其中92.6%(25/27)定位于细胞质。EBV核抗原1(EBNA-1)、潜伏膜蛋白1(LMP-1)及EBNA-2的检出率分别为83.8%(67/80)、81.3%(65/80)和56.3%(45/80),EBV裂解蛋白ZEBRA未检出,Ⅲ型潜伏感染占41.3%(33/80)。相比之下,HPV DNA检出率仅2.6%(8/304),其中2例p16-IHC阳性,EBV-HPV共感染OSCC仅1例。结论 以中山大学附属医院标本为例,广州地区OSCC中EBV检出率较高,以Ⅲ型潜伏感染为主,EBER主要定位于细胞质,提示EBV可能在OSCC发病机制中发挥作用。相比之下,HPV相关OSCC罕见,其致病作用有限。

     

    Abstract: Objective To investigate the infection status and clinicopathological characteristics of Epstein-Barr virus(EBV)and human papillomavirus(HPV)in oral squamous cell carcinoma(OSCC)in Guangzhou,China. Methods A total of 304 OSCC specimens were collected from Guangzhou,including 123 cases from the Third Affiliated Hospital of Sun Yat-sen University(January 2014 to December 2024)and 181 cases from Sun Yat-sen Memorial Hospital of Sun Yat-sen University(January 2017 to December 2018). Polymerase Chain Reaction(PCR)was used to detect viral DNA,in situ hybridization was used to assess EBV-encoded RNAs(EBER),and immunohistochemistry was performed to identify viral-related proteins and determine the type of infection. Results Among the 304 OSCC specimens,26.3%(80/304)were EBV-PCR positive,with 63.8%(51/80)diagnosed at TNM stage I/II. Compared with EBV-negative cases,the difference in tumor staging was statistically significant(P = 0.042). Among the EBV-PCR-positive OSCC cases,the EBER-positive rate was 33.8%(27/80),with 92.6%(25/27)localized in the cytoplasm. The detection rates of EBV-encoded nuclear antigen-1(EBNA-1),latent membrane protein-1(LMP-1),and EBV-encoded nuclear antigen-2(EBNA-2)were 83.8%(67/80),81.3%(65/80),and 56.3%(45/80),respectively,while the lytic protein ZEBRA was not detected. Type III latent infection accounted for 41.3%(33/80). In contrast,HPV DNA was detected in only 2.6%(8/304)of OSCC cases,among which two were p16-IHC positive. Only one case of OSCC showed EBV-HPV coinfection. Conclusions Based on samples collected from Sun Yat-sen University affiliated hospitals,EBV infection is relatively prevalent in OSCC cases in Guangzhou,mainly characterized by type III latency and cytoplasmic localization of EBER,suggesting a potential role of EBV in the pathogenesis of OSCC. In contrast,HPV-related OSCC appears to be rare and likely plays a limited pathogenic role.

     

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