Mehmet GÜVEN, Ahmet EYİBİLEN, Reşit Doğan KÖSEOĞLU, İbrahim ALADAĞ, Nurper FİLİZ

Kronik tekrarlayıcı tonsillit-adenotonsiller hipertrofi de Epstein barr virüs ve Herpes simpleks virüs tip 1 analizi

Bu çalışmada amacımız, kronik tekrarlayıcı tonsillitis/adenotonsiller hipertrofi (KTT/ATH) olgularının patogenezinde, Epstein Barr virüs (EBV) ve Herpes simpleks tip 1 virüsünün (HSV tip 1) rolünü immünohistokimyasal (İHK) ve in situ hibridizasyon (İSH) yöntemleri ile araştırmaktır. GEREÇ VE YÖNTEM Çalışmaya toplam 50 KTT/ATH olgusunun adenotonsillektomi materyali dahil edilmiştir. Parafin kesitlerde İHK yolla EBV LMP, EBNA-2, EBV early Ag, HSV tip-1, CD3, CD10, CD20, CD21 ve CD56 antikorları ve İSH yoluyla EBV için DNA-DNA hibridizasyonu uygulanmıştır. BULGULAR Olguların yaşları 4 ile 32 arasında değişmiştir. Olguların 32'si kadın, 18'i erkektir. Toplam 8 olguda (%16) EBV genomu saptanırken, HSV hiç bir olguda tespit edilmedi. EBV genomu saptanan olguların tamamında ekstrafolliküler lenfoid hücrelerde pozitiflik görüldü. Sadece 2 olguda ilaveten anti-EBV early antijen ile skuamöz hücrelerde de pozitiflik saptandı. İSH yöntemi ile sadece 4 olgu (%8) EBV genomu için pozitif idi. EBV genomu pozitif lenfoid hücrelerinin tamamı CD20 (+) B-lenfosit fenotipine sahipti. SONUÇ Çalışmamızda EBV genomu pozitif olguların oranı (%16), literatürde rapor edilen sınırlar içerisindeydi. İSH' de saptanan pozitiflik oranının düşüklüğü (%8) işlemin uygulanmasındaki hassasiyet gerektiren sıcaklık ve nem gibi faktörlerden kaynaklanmış olabilir. EBV genomu saptanan lenfoid hücrelerin tiplendirmesi ve lokalizasyonu literatür verileri ile uyumlu idi. Literatürde daha çok EBV' nin KTT/ATH ile olası ilişkisi üzerine yayınlar mevcuttur. Bu çalışmalardan anlamlı olabilecek sonuçlar elde edilmiş olmakla birlikte daha geniş seriler üzerinde yapılmış çalışmaların sonuçlarına ihtiyaç olduğu anlaşılmaktadır. HSV ile KTT/ATH arasındaki ilişkiyi araştıran makale sayısı son derece sınırlı olup olası bir ilişkiden söz etmek mümkün görünmemektedir.

The analysis Of Epstein barr virus and Herpes simplex virus type 1 in chronic recurrent tonsillitis-adenotonsillar hypertrophy

AIM We objected to investigate a probable role of Epstein-Barr virus (EBV) and Herpes simplex virus type 1 (HSV type-1) by immunohistochemistry (IHC) and in situ hybridization (ISH) in patogenesis of chronic recurrent tonsillitis/adenotonsillar hypertrophy (CRT/ATH) in this study. MATERIALS-METHODS Adenotonsillectomy materials of fifty cases with CRT/ATH were included in the study. EBV LMP, EBNA-2, EBV early Ag, HSV tip-1, CD3, D10, CD20, CD21 and CD56 antibodies in IHC and DNA-DNA hybridization for EBV in ISH were performed on paraffin sections. RESULTS The age of cases ranged from 4 to 32 years. The thirty-two cases were female and 18 cases were male. EBV genome was determined in 8 cases (16%), while HSV type 1 was not observed in any cases. The positive lymphoid cells for EBV were observed in extrafollicular areas of lymphoid tissues, while only 2 cases were also positive for EBV early antigen in squamous cells in addition to positive lymphoid cells in extrafollicular areas. In only 4 of cases (8%), EBV genome was determined by ISH. Postive lymphoid cells for EBV genome were CD20 (+) B-lymphocytes. CONCLUSION The rate of cases bearing EBV genome in our study (%16) was within the limits reported in the literature. The low rate (8%) of positive cases determined by ISH for EBV could be due to the factors such as heat and humidity of environment directly affected the results of process. The location and subtypes of positive lymphoid cells for EBV were concordant with data of literature. The articles investigating a probable relation between EBV and CRT/ATH are more than that of HSV in the literature. Although the meaningful results have been obtained from these studies, the results which will be obtained from the larger series are needed. The number of articles searching a probable relation between HSV and CRT/ATH are very few and for this reason, it is not possible to talk about a probable relation.

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