Abstract
目的 探讨EB病毒在鼻咽癌形态发生学的哪一阶段进入鼻咽上皮细胞.方法从3212例鼻咽癌活检组织切片中筛选并收集到具有各种癌旁上皮病变的鼻咽癌标本85例,用核酸原位杂交法检测癌旁上皮病变中EB病毒编码的小RNAs(EBERs)感染,其中31例具有癌旁鳞状化生病变的鼻咽癌组织进一步用核酸原位杂交法检测EB病毒溶解期产物EA-D(earlyantigen-diffuse)mRNA.结果85例鼻咽癌标本共观察到154个癌旁上皮病变病灶:39个柱状上皮单纯增生灶、43个化生鳞状上皮增生灶、41个上皮异型性变(轻度、中度和重度)灶、17个原位癌灶及14个微小浸润癌灶.所有癌旁正常或单纯增生的柱状上皮、化生鳞状上皮均显示EBERs阴性.一部分(11/41,26.83%)癌旁异型性变上皮中的少数细胞表达EBERs,大部分原位癌(12/17,70.59%)及全部微小浸润癌都显示相当数量的EBERs阳性癌细胞.31例可见癌旁鳞状化生上皮病变的鼻咽癌中有10例癌旁上皮角化细胞的细胞核上显示出EA-DmRNA阳性信号.结论EB病毒可以首先感染异型性变的上皮细胞,然后可能与其他致癌产物协同对鼻咽癌变过程起了重要的作用.此外,从鼻咽癌细胞中释出的EB病毒可以重复感染癌旁鳞状化生上皮内的角化细胞,这种溶解性感染不具有重要的病理学意义。
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