CAJ | 학술논문

目的　研究鼻腔癌（NPC）高发的广州地区鼻腔鼻窦淋巴上皮性癌（SNLEC）的发病情况，并检测其是否感染EB病毒（EBV）。方法　从广州地区8年内所有鼻腔鼻窦癌的活检标本中，收集其中确定为淋巴上皮性癌的标本20例。用原位杂交法检测EBV编码的早期RNAs，同时用免疫组化法检测各种不同的抗原，包括EBV核抗原1、潜伏膜蛋白1、EZLF1蛋白、弥漫型早期抗原、病毒壳抗原和膜抗原。此外，另取36例鼻咽癌作为对照。结果　在确诊的20例SNLEC中，17例在鼻腔，3例在上颌窦。20例SNLEC患者的平均年龄(46.25岁)、男女比例(3∶1)、组织病理学和淋巴细胞浸润的情况与36例鼻咽癌者类同。20例SNLEC中的13例(65.0%)呈膨胀型生长方式，而36例NPC中的27例(75.0%)则呈浸润型生长方式。所有20例SNLEC中的绝大多数癌细胞均显示EBV编码的早期RNAs。SNLEC和EBV核抗原1的表达强度比鼻咽癌弱，SNLEC的潜伏膜蛋白1的表达率(3/20，15.0%)低于鼻咽癌患者(19/36，52.8%)。SNLEC的BZLF1蛋白(2/20，10.0%)、弥漫型早期抗原(19/20，95.0%)、病毒壳抗原(15/20，75.0%)和膜蛋白(13/20，65.0%)的表达率均高于NPC者(0/36，0.0%;31/36,86.0%;18/36,50%和14/36,38.9%)。结论　在广州地区，SNLEC并非少见。与NPC一样，SNLEC总是与EBV感染有关。与NPC相比，SNLEC中感染的EBV所表达的EB病毒核抗原1信号较弱，潜伏膜蛋白1表达率较低，而EBV溶解期产物的表达率却较高。
목적　연구비강암（NPC）고발적엄주지구비강비두림파상피성암（SNLEC）적발병정황，병검측기시부감염EB병독（EBV）。 방법　종엄주지구8년내소유비강비두암적활검표본중，수집기중학정위림파상피성암적표본20례。용원위잡교법검측EBV편마적조기RNAs，동시용면역조화법검측각충불동적항원，포괄EBV핵항원1、잠복막단백1、EZLF1단백、미만형조기항원、병독각항원화막항원。차외，령취36례비인암작위대조。 결과　재학진적20례SNLEC중，17례재비강，3례재상합두。20례SNLEC환자적평균년령(46.25세)、남녀비례(3∶1)、조직병이학화림파세포침윤적정황여36례비인암자류동。20례SNLEC중적13례(65.0%)정팽창형생장방식，이36례NPC중적27례(75.0%)칙정침윤형생장방식。소유20례SNLEC중적절대다수암세포균현시EBV편마적조기RNAs。SNLEC화EBV핵항원1적표체강도비비인암약，SNLEC적잠복막단백1적표체솔(3/20，15.0%)저우비인암환자(19/36，52.8%)。SNLEC적BZLF1단백(2/20，10.0%)、미만형조기항원(19/20，95.0%)、병독각항원(15/20，75.0%)화막단백(13/20，65.0%)적표체솔균고우NPC자(0/36，0.0%;31/36,86.0%;18/36,50%화14/36,38.9%)。 결론　재엄주지구，SNLEC병비소견。여NPC일양，SNLEC총시여EBV감염유관。여NPC상비，SNLEC중감염적EBV소표체적EB병독핵항원1신호교약，잠복막단백1표체솔교저，이EBV용해기산물적표체솔각교고。
Objectives　To investigate the prevalence of sinonasal lymphoepithelial carcinoma (SNLEC) in Guangzhou, a high incidence area of nasopharyngeal carcinoma (NPC), and to detect whether it is associated with Epstein-Barr virus (EBV) infection. Methods　Twenty confirmed SNLEC specimens were collected from all of the sinonasal carcinoma biopsies performed in the 8 years 1989-1996 at the Sun Yat-sen University of Medical Sciences. EBV encoded early RNAs were detected by use of in-situ hybridization. A variety of antigens, including the EBV nuclear antigen 1, latent membrane protein 1, BZLF1 protein, diffuse early antigen, viral capsid antigen and membrane antigen, were detected using immunohistochemistry. Additionally, 36 NPC specimens were used for comparison. Results　Twenty SNLECs were identified. Seventeen SNLECs were developed in the nasal cavity, and 3 in the maxillary sinus. The mean age (46.25 y), male to female ratio (3∶1), histopathology and lymphoinfiltration of the 20 SNLECs were identical with those of the 36 NPCs. Thirteen (65.0%) of the 20 SNLECs showed an expansive growth pattern, while 27 (75.0%) of the 36 NPCs showed an infiltrating or mixed growth pattern. The majority of cancer cells in all of the 20 SNLECs showed EBV encoded early RNAs. The EBV nuclear antigen 1 expression of SNLEC was less intensive than that of NPC. The expression rate of latent membrane protein 1 for SNLEC (3/20,15%) was lower than that for NPC (19/36, 52.8%). The expression rates of BZLF1 protein (2/20, 10.0%), diffuse early antigen (19/20, 95.0%), viral capsid antigen (15/20, 75.0%), and membrane antigen (13/20, 65.0%) for SNLEC were higher than those (0/36, 0.0%; 31/36, 86.0%; 18/36, 50%; and 14/36, 38.9%) for NPC. Conclusions　SNLEC is not uncommon in Guangzhou. This tumour is also consistently associated with EBV infection like NPC. As compared to NPC, the EBV harbored in SNLECs seems to express the EBV nuclear antigen 1 weakly and has a lower expression rate of latent membrane protein 1 as well as higher expression rates of EBV lytic products.