原发性肺淋巴上皮瘤样癌20例临床病理分析

发布时间：2018-02-01 13:17

本文关键词： 肺肿瘤淋巴上皮瘤样癌临床病理基因突变　出处：《临床与实验病理学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨原发性肺淋巴上皮瘤样癌(lymphoepithelioma-like carcinoma,LELC)的临床病理特点、治疗及预后。方法回顾性分析20例原发性肺LELC的临床资料、病理形态、免疫表型、治疗等,并复习相关文献。结果镜下癌细胞呈合体样、巢片状排列生长;细胞核大、空泡状,核仁明显,细胞异型较大,间质内具有丰富的淋巴细胞浸润,类似鼻咽未分化癌的形态。免疫表型:癌细胞CKpan(20/20)、EBER(20/20)、CK5/6(19/20)、p63(18/20)及p40(16/20)均阳性。3例行EGFR基因突变检测阴性,2例行EML4-ALK融合基因检测阴性,1例行K-RAS基因突变检测阴性。治疗以手术、放化疗等综合治疗为主。结论原发性肺LELC是肺部少见的恶性肿瘤,组织形态及免疫组化是诊断的主要手段,但要排除其他部位转移;同时EGFR、ALK等肺癌常见基因突变在肺LELC中少见,PD1/PD-L1突变可能有一定的潜在治疗价值。目前,临床仍以经验性治疗为主。
[Abstract]:Objective to investigate the clinicopathological features of primary lymphoepithelioma-like carcinomatous carcinoma (LELC). Methods the clinical data, histopathology, immunophenotype and treatment of 20 cases of primary lung LELC were analyzed retrospectively. Nest flake arrangement growth; The nucleus is large, vacuolar, nucleolus is obvious, the cell is abnormal, the interstitial has abundant lymphocyte infiltration, similar to nasopharynx undifferentiated carcinoma morphology. Immunophenotype: cancer cell CKpanus 20 / 20). EBERN 20 / 20 CK5 / 6 / 19 / 20 p63 / 18 / 20 and p40 / 16 / 20) were positive for EGFR gene mutation. EML4-ALK fusion gene was negative and K-RAS gene mutation was negative in 2 cases. Conclusion Primary pulmonary LELC is a rare malignant tumor of the lung. Histology and immunohistochemistry are the main methods for diagnosis, but other metastatic sites should be excluded. At the same time, the common gene mutations such as EGFR rlk and other common gene mutations in lung cancer may have potential therapeutic value in lung LELC. At present, empirical therapy is still the main clinical practice.
【作者单位】：福建医科大学附属协和医院病理科;
【分类号】：R734.2
【正文快照】： 淋巴上皮瘤样癌(lymphoepithelioma-like carci-noma,LELC)为临床少见的未分化恶性肿瘤;好发于鼻咽部,少数发生于胃、肺、口腔等。肺部原发性LELC比较少见,Begin等[1]于1987年首次报道。近几十年,国内肺LELC的报道仍较少,其病因不明确,组织学形态与鼻咽的未分化癌类似,并且与E

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