EBER检测在儿童淋巴结活检中的意义

Significance of EBER Detection in Lymph Node Biopsy of Children

摘要: 目的：儿童淋巴结肿大在临床中很常见，病因很多，通过临床详细体格检查、实验室检查以及病理检查，能够确诊。EB病毒(Epstein Barr Virus, EBV)感染是引起儿童期淋巴结肿大的重要原因，EBER检测是确定EBV感染的金标准，探讨其在儿童淋巴结活检中的意义。方法：收集伴有浅表淋巴肿大的行淋巴结活检术的患者60例，病理标本全部行EBER检测，对其临床、实验室资料、病理、预后进行统计分析。结果：60例淋巴结肿大患儿，19例行淋巴结切除活检，39例行淋巴结穿刺活检术，组织坏死性淋巴结炎占22例(36.7%)，肿瘤性疾病占15例(25%)，EBV感染和传染性单核细胞细胞增多症占11例(18.3%)，其余诊断占12例(20%)。所有患者行组织病理检查，其中EBER检测阳性的14例，在传染性单核细胞疾病中占比例最高(100%)。中位随访37个月，EBER阳性患者的无事件生存期明显短于EBER阴性患者，有统计学意义(P < 0.01)。结论：EBV感染是导致小儿浅表淋巴结肿大的重要病因，EBER阳性患者更能更容易出现疾病复发，需要动态长期随访。

Abstract: Objective: The children lymph node enlargement is very common in the clinic, the etiology is many, through the clinical detailed physical examination, the laboratory examination and the pathological examination, can diagnose. EB virus infection is an important cause of infantile lymphadenopathy. EBER test is the gold standard for determining EB virus infection and discusses its significance in pediatric lymph node biopsy. Methods: 60 cases of lymph node biopsy with superficial lymphatic enlargement were collected. All pathological specimens were examined with EBER, and their clinical, laboratory data, pathology, and prognosis were statistically analyzed. Results: 60 children with lymph node enlargement, 19 lymph node resection biopsies, 39 lymph node puncture biopsy procedures, 22 cases (36.7%) of tissue necrotizing lymphadenitis, 15 cases (25%) of tumor diseases, EB virus infection and infectious monocytes increased 11 cases (18.3%). The remaining diagnosis accounted for 12 cases (20%). Histopathological examinations were performed in all patients, of which 14 were positive for EBER and accounted for the highest proportion of infectious mononuclear cell diseases (100%). In 37 months of median follow-up, the non-event lifetime of EBER positive patients was significantly shorter than that of EBER negative patients and was statistically significant (P0.01). Conclusion: EB virus infection is an important cause of superficial lymphadenopathy in children. EBER positive patients are more likely to relapse and require dynamic long-term follow-up.