RESUMO
Epstein-Barr virus (EBV) has been demonstrated in association with Hodgkin's disease (HD) in approximately 40 to 50% of cases in series from North America, Europe, and Japan. However, few data are available concerning this association in developing countries. Recent studies, including mostly a pediatric population from Peru and a pediatric population from Honduras, showed a higher percentage of EBV positivity compared with those in developed countries. To determine the prevalence of EBV in Hodgkin's disease in a Mexican adult population, we analyzed 50 formalin-fixed, paraffin-embedded cases of HD by a three-step technique using a monoclonal antibody to the latent membrane protein of EBV. All the cases were confirmed immunophenotypically as HD (CD15+ and/or CD30+, CD45-). Reed-Sternberg cells and variants were positive for LMP in 35 cases (70%). The staining was found both on the cell surface and/or within the cytoplasm with enhancement of the Golgi area. EBV latent membrane protein was found in 1/1 case (100%) of diffuse lymphocyte-predominant HD, 10/20 cases (50%) of nodular-sclerosis, 18/22 cases of mixed-cellularity (81%), and 6/7 (86%) cases of lymphocyte-depleted HD. Our results show a high prevalence of EBV in HD in this Mexican adult population. All histologic subtypes of HD in the population analyzed appear to be strongly associated with EBV, in contrast to the strong association of mixed cellularity HD in developed countries. Patient age and gender were not predictive of the presence of EBV.
Assuntos
Herpesvirus Humano 4/isolamento & purificação , Doença de Hodgkin/virologia , Proteínas da Matriz Viral/análise , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Feminino , Herpesvirus Humano 4/química , Doença de Hodgkin/patologia , Humanos , Imuno-Histoquímica , Imunofenotipagem , Linfonodos/patologia , Masculino , México , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
The Epstein-Barr virus (EBV) has been demonstrated in association with cases of Hodgkin's disease (HD) indicating that, in at least in some cases, EBV may play a pathogenic role in the development of HD. To determine the prevalence of EBV in HD in a Mexican adult population, we studied 39 formalin-fixed and/or B-5, paraffin embedded samples of patients with HD, by immunoperoxidase; in situ hybridization was done in 32 of the 39 cases. We analyzed the presence of the latent membrane protein (LMP) and EBV-specific DNA sequences. Reed-Sternberg cells and mononuclear variants were positive for LMP in 28 cases (72%). LMP staining was found both on the cell surface and/or within the cytoplasm with enhancement in the Golgi area. The LMP was found in the single case of diffuse lymphocyte predominant HD, in 6/12 cases of nodular sclerosis (50%), in 10/15 cases of mixed cellularity (67%) and in all eleven cases of lymphocyte depleted HD (100%). No EBV-specific DNA sequences were found by in situ hybridization. Our results show: 1) a higher association of EBV in our population compared to the approximately 48% reported in developed countries; 2) all histologic subtypes of HD in Mexico appear to be strongly associated with EBV in contrast to the strong association with only mixed cellularity seen in Western populations; 3) the high prevalence of EBV in HD in Mexico may be a function of histology, ethnic groups, socioeconomic factors and/or geography.