原发性肺淋巴上皮瘤样癌的临床分析

目的探讨原发性肺淋巴上皮瘤样癌（LELC）的临床病理特点和治疗方法。方法回顾性分析11例肺LELC患者的临床资料。结果11例肺LELC患者中，男5例，女6例，均来自我国华南地区；年龄33～63岁，中位年龄41岁。肺LELC在组织学上表现为癌细胞呈合胞体状聚集成堆，细胞核呈空泡状，肿瘤间质有淋巴细胞浸润。11例患者的细胞角蛋白（CK）免疫组化染色均为阳性；原位杂交检测EBV小RNA（EBERs）的阳性率为88．9％。7例患者接受手术治疗，其中单纯手术2例，手术＋化疗3例，手术＋化疗＋放疗2例；4例不能手术的患者接受了化疗或化疗＋放疗。9例患者存活至今，其中6例为无瘤生存者，最长生存时间为52个月；3例为带瘤生存者，最长生存时间为89个月。结论原发性肺LELC可能与EB病毒感染有关，其对放疗和化疗有一定的敏感性，宜采用以手术为主的综合治疗，预后较好。

Cliulcul analysis of primary lymphoepithelioma-like carcinoma of the lung

Objective To investigate the clinicopathologic characteristics and effective treatment method for primary lymphoepithelioma-like carcinoma (LELC) of the lung. Methods Clinical and pathological materials of 11 patients with lung LELC were retrospectively analyzed. Results There were 5 male and 6 femal in this series, and all of them were from southern China. The range of age was 33 to 63 years with a median age of 41years. Histological study showed cohesive clusters of comprising syncytial- appearing cells with vesicular nuclei and tumor-infiltrating lymphocytes. The cytokeratin was positively detected in all 11 cases by immunohistochemistry staining. The positive rate of EBV-encoded small nuclear RNA(EBERs) was positively detected by in situ hybridization in 88.9% of them. Of these 11 patients, 7 were treated with surgery ( surgery alone in 2, surgery plus postoperative chemotherapy in 3 and surgery plus postoperative chemotherapy and radiotherapy in 2 ); the remain 4 had inoperable disease and received palliative chemotherapy±radiotherapy. Nine patients were still alive when the follow-up ended, of those 6 were disease-free with a longest survival period of 52 months; 3 were disease-bearing with a longest survival period of 89 months. Conclusion Lymphoepithelioma-like carcinoma of the lung may be associated with Epstein-Barr virus infection, and which may response to chemotherapy and radiotherapy. Surgery-based multimodality therapy may be suitable to achieve satisfied prognosis.