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目的 分析口腔鳞状细胞癌（OSCC）中EB病毒（EBV）感染的病理特点，并构建其生存预测模型。方法 回顾性收集2019年3月至2024年3月就诊于本院的79例OSCC患者，采用EBV编码小RNA原位杂交（EBER-ISH）明确感染类型，将患者分为EBV阳性组与EBV阴性组，采用实时荧光定量聚合酶反应（qRT-PCR）及免疫组织化学检测比较2组临床病理特征。另根据5年生存情况，将患者分为生存组与死亡组，分析影响其死亡的因素，构建其生存预测模型。结果本研究共纳入79例原发性OSCC患者，检出EBV阳性患者24例，EBV阳性率为30.38%。口腔鳞状细胞癌EB感染（OSCC-EBV）男性占比高于女性，临床表现以口腔黏膜无痛性溃疡、黏膜白斑伴糜烂为主，颈部淋巴结无痛性肿大发生率较高。EBV感染以巢周型定位、高病毒载量、弥漫型分布为主，淋巴上皮样改变18例，发生率为75%，且以轻度为主。基于Logistic多因素构建的列线图模型AUC为0.897,95%CI为0.827～0.966，灵敏度为0.823，特异度为0.870；校准曲线拟合良好，决策曲线显示模型具有较好的临床适用性。结论OSCC-EBV多发于男性，临床表现以口腔黏膜无痛性溃疡、黏膜白斑伴糜烂为主，颈部淋巴结无痛性肿大发生率较高，EBV感染以巢周型定位、高病毒载量、弥漫型分布为主，且常伴有淋巴上皮样改变。
Abstract：Objective To analyze the pathological characteristics of Epstein-Barr virus(EBV) infection in oral squamous cell carcinoma(OSCC) and construct a survival prediction model for the disease. Methods A total of 79 OSCC patients admitted to our hospital from March 2019 to March 2024 were retrospectively enrolled. EBV-encoded small RNA in situ hybridization(EBER-ISH) was performed to determine the infection status, and the patients were divided into an EBV-positive group and an EBV-negative group. Quantitative real-time polymerase chain reaction(qRT-PCR) and immunohistochemistry were applied to compare the clinicopathological features between the two groups. Additionally, all patients were categorized into a survival group and a death group according to their 5-year survival outcomes. The risk factors for mortality were analyzed, and a survival prediction model was established accordingly. Results Among the 79 primary OSCC patients enrolled, 24 cases were identified as EBV-positive, with a positive rate of 30.38%. The proportion of males was higher than that of females in the OSCC-EBV subgroup. The main clinical manifestations included painless oral mucosal ulcers, leukoplakia with erosion, and a relatively high incidence of painless cervical lymphadenopathy. EBV infection was predominantly characterized by perinestal localization, high viral load and diffuse distribution. Lymphoepithelial-like changes were observed in 18 cases(75%), mostly mild in severity. The nomogram model constructed based on multivariate Logistic regression analysis showed an area under the curve(AUC) of 0.897(95% confidence interval [CI]: 0.827 – 0.966), with a sensitivity of 0.823 and a specificity of 0.870. The calibration curve demonstrated good fitting, and the decision curve analysis indicated favorable clinical applicability of the model. Conclusion OSCC associated with EBV infection is more prevalent in males, with main clinical manifestations including painless oral mucosal ulcers, leukoplakia with erosion, and a high incidence of painless cervical lymphadenopathy. EBV infection in OSCC is mainly featured by perinestal localization, high viral load and diffuse distribution, often accompanied by mild lymphoepitheliallike changes.
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基本信息:
中图分类号:R739.8
引用信息:
[1]王恪钢,王习超,张文静.口腔鳞状细胞癌中EB病毒感染病理特点及生存预测模型的建立[J].病毒学报().
基金信息:
2024年度河南省医学科技攻关计划项目（项目号：LHGJ2024794）,题目：甲芬那酸联合硝酸银治疗牙周炎的分子机制研究
2026-06-09
2026-06-09
2026-06-09