摘要
目的探讨肺淋巴上皮癌(lymphoepithelial carcinoma,LEC)的临床病理学特征及PD-1/PD-L1在肺LEC中的表达及临床意义。方法采用免疫组化法对41例肺LEC进行检测;回顾性分析41例肺LEC的临床病理学特征及随访结果,并复习相关文献。结果41例肺LEC中,男性22例,女性19例,发病年龄27~77岁,中位年龄54岁,4例有吸烟史。临床症状主要表现为咳嗽、咳痰、咯血及胸闷,或体检发现肺部结节。免疫表型:肿瘤细胞表达CK5/6(41/41)、p40(41/41)、p63(41/41)、PD-L1(37/41),其中16例(16/41)肿瘤细胞PD-L1呈高表达;17例(17/41)肿瘤间质淋巴细胞表达PD-1。PD-L1和PD-1表达与LEC患者年龄、性别、吸烟状况、肿瘤分期等临床病理特征均无相关性(P>0.05)。11例行基因检测,均未发现RET、ROS1、EGFR、HER-2、PIK3CA、BRAF、KRAS和ALK基因突变。41例患者均行手术切除术,术后随访6~54个月,均存活,其中3例分别出现胸腔、肝和骨部位转移。结论肺LEC是一种罕见的恶性肿瘤,常见于非吸烟的年轻患者,大多数患者缺乏ALK和EGFR等常见基因突变,肿瘤细胞及间质淋巴细胞PD-L1、PD-1阳性率高,表明LEC的发生发展可能与PD-L1、PD-1表达有关,可为临床开展免疫治疗提供理论基础。
Purpose This study aimed to investigate the clinicopathological characteristics of pulmonary lymphoepithelial carcinoma(LEC),and the expression and clinical significance of PD-1/PD-L1 in pulmonary LEC.Methods The clinicopathological data,immunophenotype,PD-1/PD-L1 expression and follow-up results of 41 cases of pulmonary LEC were collected and retrospectively analyzed.The relevant literatures were reviewed.Results There were 41 cases of pulmonary LEC in this study,including 22 males and 19 females,aged from 22 to 77 years(median age 54 years).Four patients had a history of smoking.The clinical manifestations were cough,expectoration,hemoptysis,chest tightness or pulmonary nodules.Immunohistochemical staining revealed all of the tumor cells expressed CK5/6(41/41),p40(41/41)and p63(41/41).Meanwhile,37 of the 41 cases(37/41)expressed PD-L1,among which 16 of the 41 cases(16/41)showed high positive expression of PD-L1,while 17 of the 41 cases(17/41)showed high positive expression of PD-1 in tumor-infiltrating lymphocytes.The expressions of PD-L1 and PD-1 in pulmonary LEC were not significantly correlated with clinicopathological features(age,gender,smoking status,tumor stage,etc)(P>0.05).None of the 11 cases had mutations in RET,ROS1,EGFR,HER-2,PIK3 CA,BRAF,KRAS and ALK genes.All 41 patients underwent surgical resection,and the follow-up time ranged form 6 to 54 months.At the last follow-up,all patients were alive except for 3 cases who presented with tumor metastasis,which occurred in the thoracic cavity,liver and bone,respectively.Conclusion Pulmonary LEC is a rare malignant tumor that commonly occurs in young non-smoking patients.Most patients lack common gene mutations such as ALK and EGFR,the high positive expression of PD-L1 and PD-1 in tumor cells and tumor-infiltrating lymphocytes,indicating that the occurrence and development of LEC may be related to the positive expression of PD-L1 and PD-1,which can provide a theoretical basis for clinical immunotherapy.
作者
马善宝
郑巧灵
延永琴
齐兴峰
刘庆宏
曲利娟
MA Shan-bao;ZHENG Qiao-ling;YAN Yong-qin;QI Xing-feng;LIU Qing-hong;QU Li-juan(Department of Pathology,the 900th Hospital of Joint Logistics Support Force,Fuzhou 350003,China;Department of Pathology,Fuzhou Second Hospital of Xiamen University,Fuzhou 350007,China;Department of Pathology,Fujian Medical University Union Hospital,Fuzhou 350001,China)
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2022年第12期1469-1474,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
福建省临床重点专科建设项目(2015ZDZKBL)。
关键词
肺肿瘤
淋巴上皮癌
PD-L1
PD-1
免疫治疗
lung neoplasms
pulmonary lymphoepithelial carcinoma
PD-L1
PD-1
immunotherapy
