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目的:分析儿童EB病毒(EBV)阳性弥漫大B细胞淋巴瘤(DLBCL)的临床病理特点、治疗及预后,以提高儿科医师对本病认识。方法:收集2016年1月至2019年12月在北京儿童医院初诊并规律治疗的6例EBV阳性DLBCL患儿资料,包括基本信息(性别、年龄、首发症状、病程),病理结果[免疫组织化学、EBV编码的核糖核酸(EBER)、潜伏膜蛋白(LMP)、n C-n MYC基因],免疫功能,血EBV指标及治疗方案、预后。n 结果:男4例,女2例,平均年龄6.67岁,病初尿酸266.2 μmol/L,乳酸脱氢酶水平346.5 U/L,1例存在免疫缺陷病。化疗前免疫功能检测提示4例患儿辅助性T淋巴细胞比例下降,体液免疫功能均正常。6例患儿EBV抗体均无近期感染依据;3例EBV-DNA增高。Ⅲ期2例,Ⅳ期4例,巨大瘤灶者1例,B症状者2例,结外侵犯者6例,中枢侵犯者4例,骨髓侵犯者1例。治疗分组:B组2例,C组4例。3例死亡,3例至今存活。6例患儿病理形态均为单型性,免疫组织化学:1.患儿均表达CDn 19、CDn 20、CDn 79a,5例表达CDn 30。2.患儿均经免疫荧光原位杂交方法检测n C-n MYC基因,未见MYC、Bcl-2及Bcl-6的断裂及扩增。3.EBV:患儿均表达EBER及LMP-1。n 结论:EBV阳性DLBCL病理改变与成人相似,非生发中心来源更多见,就诊时结外侵犯、中枢侵犯较常见。本病伴中枢侵犯的患儿预后极差,疾病复发、进展多出现在治疗中或停药早期,目前尚无有效、可行的治疗方案,建议晚期患者在强化疗结束后尽快行异基因造血干细胞移植以提高生存率。“,”Objective:To analyze the clinicopathological features, treatment and prognosis of Epstein -Barr virus(EBV) positive diffuse large B cell lymphoma(DLBCL) in children, so as to improve the knowledge of pediatricians on this disease.Methods:The data of 6 cases of EBV positive DLBCL who were initially diagnosed and regularly treated in Beijing Children′s Hospital from January 2016 to December 2019 were collected, including basic information (gender, age, first symptom, and course of disease), pathological results [immunohistochemistry, EBV encoded RNA(EBER), latent membrane protein(LMP), and n C-n MYC gene], immune function, EBV index, treatment group, treatment plan and prognosis.n Results:There were 4 males and 2 females, with the average age of 6.67 years.The uric acid was 266.2 μmol/L, lactic dehydrogenase(LDH) was 346.5 U/L at early stage, and 1 patient had immunodeficiency.The immune function test before chemotherapy indicated that the proportion of auxiliary T cells decreased in 4 cases, and the humoral immune function was normal in all patients.There was no evidence of recent infection in 6 patients, and EBV-DNA increased in 3 patients.There were 2 cases of stage Ⅲ, 4 cases of stage Ⅳ, 1 case of giant tumor, 2 cases of symptom B, 6 cases of extranodal invasion, 4 cases of central invasion and 1 case of bone marrow invasion.Three patients died and three survived.Immunohistochemistry showed that: (1) CD n 19, CDn 20, and CDn 79a were expressed in all patients, and CDn 30 was expressed in 5 patients.(2) n C-n MYC gene was detected by immunofluorescence in situ hybridization method in all patients, and no MYC break, Bcl-2 and Bcl-6 break and amplification were found.(3) EBV: EBER and LMP-1 were expressed in all patients.n Conclusions:The pathological changes of EBV positive DLBCL are similar to those adults.The origin of non-germinal center and extranodal and central invasion are more common.The prognosis of the patients with central nervous system invasion is very poor, and the recurrence and progress of the disease often occur in the treatment or in the early stage of drug withdrawal.At present, there is no effective and feasible treatment plan.It is suggested that the patients in the late stage should receive allogeneic hematopoietic stem cell transplantation as soon as possible after intensive treatment, so as to improve the survival rate.