Comparison of Epstein-Barr Virus Markers in Reed-Sternberg Cells in Adult Hodgkin's Disease Tissues from an Industrialized and a Developing Country

Abstract

The link between Hodgkin's disease (HD) and Epstein-Barr virus (EBV) is well documented in childhood and here the same hypothesis has been examined in adults, by comparing cases from an industrialized and a developing country. In this study the prevalence of EBV markers in nodal lesions of adult HD were compared in 21 patients from France (Fr) and 25 from Algeria (A1), all clinically staged during 1990-1992. Median age was 29 years. Histologic subtypes included lymphocytic predominance (LP) Fr 1; nodular sclerosis (NS) Fr 16, Al 16; mixed cellularity (MC) Fr 4, Al 9. EBV markers examined included expression of latent membrane protein (LMP) in Reed-Sternberg and Hodgkin cells (RSC) by immunochemistry; EBV-DNA and -RNA in situ hybridization (ISH); EBV-DNA by polymerase chain reaction (PCR). Results showed that RSC were LMP-positive in 4 (2 NS, 2 MC) French and 7 (3 NS, 4 MC) Algerian. All LMP+ cases were also positive for EBV DNA-RNA ISH. ISH was positive in RSC of 33% of the French and 72% of Algerian patients (P < 0.02). The positivity was more frequent in MC (77%) than in other histologic types (45%). The EBV genome was detected by PCR on DNA extracted from frozen samples in 84% of Fr and 95% of Al patients (100% of MC and 86% of other histologic types).

Conclusion. The discrepancy between PCR and ISH results may be due to the lesser sensitivity of the ISH technique, or, alternatively, to the presence of EBV in the lymphoid cells surrounding RSC. More pronounced ISH positivity in Al young adult cases may result from the age at primary EBV infection, which is earlier in Algeria than in France.

Key Words:

• developing countries
• Epstein-Barr virus
• Hodgkin's disease
• industrialized countries