Clinical observation of pulmonary lymphoepithelioma-like carcinoma

Abstract

Background: Lymphoepithelioma-like carcinoma (LELC) of the lung is a rare type of non-small cell lung cancer (NSCLC), and researches of it are still not enough.Methods: In this study, we retrospectively analyzed 36 patients with LELC diagnosed in the Fifth Affiliated Hospital of Sun Yat-sen University and Zhaoqing First People's Hospital from January 2014 to June 2021, to investigate the clinical manifestations, tumor markers, treatment, and prognosis of LELC. Clinical data including age, gender, smoking history, family history of cancers, Epstein-Barr virus (EBV) encoding RNA (EBER) status, gene mutations, programmed death-ligand 1 (PD-L1) expression, treatment, and prognosis.Results: There was a total of 36 participants in this study, 16 males and 20 females, the median age was 57 years (37-76 years). A total of 22 cases (61.1%) were advanced (stage III and IV), and EBER was 94.4% positive. Most patients were treated with surgery, platinum chemotherapy, or radiotherapy. At the time of 31 June 2021, 33 participants had survived, and the longest survival time was 72 months. Lung LELC was more common in old participants (≥59 years) and was not associated with smoking history. Expression of PD-L1 was positive in the majority (27 cases, 75%) and participants with positive PD-L1 expression tended to have longer progression-free survival (PFS) and overall survival (OS) time than those with negative PD-L1 expression. Conclusions: Pulmonary LELC usually occurs innon-smoking patients and is associated with EBV infection. Common treatments for tumors include multimodal therapy. The expression of PD-1 may be related to the prognosis of LELC, but more studies are needed to support further optimization of the treatment of LELC.

Clinicopathological features and survival of rare primary pulmonary lymphoepithelial carcinoma: A cohort from a single center

“…In addition, the new classification considered that >90% of Asian cases were associated with EBV infection, while in European and American populations, its association with EBV was lower 6 . In this cohort, 57 out of 61 (93.4%) who were analyssed, were positive for EBER in situ hybridization, with only 4 (6.6%) exceptions, which was consistent with most findings 12,18,19 . This emphasized the correlation between EBV infection and PLEC in Asian populations 20 .…”

“…6 In this cohort, 57 out of 61 (93.4%) who were analyssed, were positive for EBER in situ hybridization, with only 4 (6.6%) exceptions, which was consistent with most findings. 12,18,19 This emphasized the correlation between EBV infection and PLEC in Asian populations. 20 Besides the high EBER positivity rate, the major driver mutations such as EGFR, KRAS, ALK, and ROS1…”

Metastatic stomach lymphoepithelioma-like carcinoma and immune checkpoint inhibitor therapy: A case report

“…The most common approach for treating LELC is multimodal therapy. The expression of PD-1/PD-L1 may be related to the prognosis of LELC[ 10 ]. Growing evidence shows that ICIs are effective against pulmonary LELC[ 5 ].…”

N6‐methyladenosine methylation regulatory pattern of pulmonary lymphoepithelioma‐like carcinoma based on exosomal transcriptome analysis

“…4,5 Unlike other types of lung cancers, classical driver mutations such as epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangements are rarely detected in pLELC. 6,7 There is limited research on the molecular characteristics and pathogenesis of pLELC and a lack of meaningful circulating biomarkers for its detection. Current research is therefore focused on elucidating the molecular landscape, searching for new biomarkers and developing potentially meaningful therapeutic targets.…”

“…This disease has been reported to be closely associated with Epstein–Barr virus (EBV) infection and is histologically similar to undifferentiated nasopharyngeal carcinoma 4,5 . Unlike other types of lung cancers, classical driver mutations such as epidermal growth factor receptor mutations and anaplastic lymphoma kinase rearrangements are rarely detected in pLELC 6,7 . There is limited research on the molecular characteristics and pathogenesis of pLELC and a lack of meaningful circulating biomarkers for its detection.…”