| Abstract | Cilj istraživanja: EBV pozitivan status kHL analiziran je u više hrvatskih studija. Cilj ovog istraživanja je ispitati epidemiološke, histološke i kliničke pokazatelje na uzroku ispitanika s kHL i utvrditi ima li razlike u dobi, spolu, podtipu i remisiji s obzirom na EBV status i prethodne hrvatske studije i literaturu.
Ispitanici i metode: U istraživanje je uključeno 108 ispitanika kojima je dijagnosticiran kHL u KBC Split u periodu od 1. siječnja 2008. godine do 11. rujna 2018. godine. Podatci o dobi, i spolu ispitanika, patohistološkoj dijagnozi i EBV statusu kHL prikupljeni su iz računalne baze Kliničkog zavoda za patologiju, sudsku medicinu i citologiju KBC-a Split, a klinički podatci iz pismohrane Klinike za unutarnje bolesti i Klinike za dječje bolesti KBC-a Split. Za 24 ispitanika koji nisu imali podatak o EBV statusu kHL, urađena je imunohistokemijska analiza iz parafinskog bloka tumorskog tkiva, uporabom primarnog protutijela na latentni membranski protein (LMP EBV, DAKO, Danska).
Rezultati: Od 108 ispitanika, 58 (53,7 %) su muškog, a 50 (46,3 %) ženskog spola. Srednja dob ispitanika je 37,95 ± 19,56 godina, raspon godina 11 do 86 godina, a medijan 32 godine. 44,86% ispitanika mlađe je od 30 godina, a 16,82% ispitanika starije je od 60. 15,88 % ispitanika je mlađe je od 18 godina. Najčešće zastupljen podtip je NS sa 71,3 % (P<0.0001). MC je zastupljen s 24,1%, a LR i LD podtipovi su rjeđe s 3,7% odnosno 0,9%. U I stadiju dijagnosticirano je 10 (9,7%), u II 53 (51,45%), u III 24 (23,3%) i u IV stadiju 16 (15,53%) ispitanika. 56,3% ispitanika imalo je B simptome. EBV pozitivan status utvrđen je u 26 od 108 (24,07%) ispitanika. Od 17 ispitanika mlađih od 18 godina 2 (11,7%) je imalo EBV pozitivan status. Udio ispitanika s EBV pozitivnim statusom kHL raste s životnom dobi te je najniži u dječjoj i mladoj odrasloj dobi (10,42%), a najveći u starijih od 60 godina (55,56%) (P=0,0002). Nije utvrđena razlika po spolu s obzirom na EBV status (P=0,076). EBV pozitivni status kHL značajno je češći u MC nego u NS, 57,7% prema 11,7% (P<0,0001). Među ispitanicima koji nisu postigli remisiju više je onih koji su imali pozitivan EBV status nego među ispitanicima koji su postigli remisiju, 62,5% prema 22,8% (P=0,0265).
Zaključci: Iako je u našoj studiji opažen veći udio NS nego u prethodnim hrvatskim studijama, postotak EBV pozitivnog kHL nije se bitno mijenjao. Udio ispitanika s EBV pozitivnim statusom kHL ima značajan trend rasta s životnom dobi, slično izvješćima iz razvijenih zemalja. U skupini koja nije postigla remisiju, značajno je više ispitanika s pozitivnim EBV statusom nego u skupini koji su postigli remisiju. |
| Abstract (english) | Objectives: The presence of EBV in cHL was analyzed in several Croatian studies. The aim of this study is to examine epidemiological, histological and clinical parameters of cHL according to age, sex, subtype, remission and EBV status and to compare these results with previous Croatian studies and literature.
Patients and methods: The study included 108 patients with cHL, consecutively diagnosed from January 1st 2008 to September 11th 2018 at University Hospital Split. Data on age and sex, pathohistological diagnosis and EBV status was collected from the computer database of the Clinical Institute of Pathology, Forensic Medicine and Cytology. Clinical data was collected from hospital records at the Internal Clinic and the Pediatric Clinic. For 24 patients who did not have known EBV status, indirect immunohistochemical analysis was performed, using primary mouse antibody for latent membrane protein (LMP EBV, DAKO, Denmark).
Results: Of the 108 patients, 58 (53.7%) are male and 50 (46.3%) female. The average age is 37.95 ± 19.56 years, range 11 to 86 years, median 32 years. 44.85% patients are younger than 30 (15.88% younger than 18) and 16.82% older than 60. The most common subtype is NS with 71.3% (P<0.0001). MC is present in 24.1% of patients, LR in 3,7% and LD in 0,9%. Stage I was established in 10 (9.7%) patients, II in 53 (51.45%), III in 24 (23.3%) and stage IV in 16 (15.53%) patients. 56.3% patients were presented with B symptoms. The EBV status of cHL was positive in 26 (24.07%) patients. Out of 17 patients younger than 18, 2 (11.7%) had positive EBV status. The EBV positive status of cHL increases with age, and it is the lowest in children and young adults (10.42%) and the highest in elderly (55.56%) (P = 0.0002). No association was found between gender and EBV status (P = 0.076). EBV positive cHL was more often found in MC than NS, 57.7% versus 11.7% (P <0.0001). In patients who did not achieve remission, EBV positive status was more common than among patients who achieved remission, 62.5% vs. 22.8% (P = 0.0265).
Conclusions: Although we found higher percentage of NS subtype than in the previous Croatian studies, the presence of EBV positive cHL remains stable. EBV status of cHL becomes positive more often with increasing age, similar to reports from developed countries. Among the patients who did not achieve remission, there were significantly more patients with positive EBV status than in the group of patients who achieved remission. |
