Clinical research progress of primary pulmonary lymphoepithelioma-like carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHANG Jinjue ¹ , CHEN Nan ^1,2 , ZHOU Jian ^1,2 ,  LIN Feng ²

1. West China Medical School, Sichuan University, Chengdu, 610041, P.R.China;
2. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

LIN Feng, Email: linfeng0220@aliyun.com

Keywords：

Pulmonary lymphoepithelioma-like carcinoma; Epstein-Barr virus; diagnosis; treatment; research progress

DOI：

10.7507/1007-4848.201901048

Video：

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Abstract Full text Figures/Tables Video References Cited by

Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is a rare type of lung cancer with special characteristics of epidemiology, clinical diagnosis, treatment and prognosis. It has close relationship with Epstein-Barr virus (EBV) infection and has prominent regional feature. Most patients are young and non-smoking. There is no specificity of clinical manifestation. Most patients are asymptomatic at the time of diagnosis. As for treatment, the standard treatment for early stage disease is complete resection. Platinum-based doublet chemotherapy has been applied in locally advanced disease as the first line therapy. Due to its rarity, the treatment of advanced PPLELC is still lack of evidence of large sample randomized controlled trial. Whether target therapy or immunotherapy is effective is worth further study. This article reviews the research progress of PPLELC, to give a particular sight for clinicians and provides a better understanding of this rare tumor for researchers.

Citation： ZHANG Jinjue, CHEN Nan, ZHOU Jian, LIN Feng. Clinical research progress of primary pulmonary lymphoepithelioma-like carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(11): 1141-1144. doi: 10.7507/1007-4848.201901048 Copy

1.	He J, Shen J, Pan H, et al. Pulmonary lymphoepithelioma-like carcinoma: a surveillance, epidemiology, and end results database analysis. J Thorac Dis, 2015, 7(12): 2330-2338.
2.	Bégin LR, Eskandari J, Joncas J, et al. Epstein-Barr virus related lymphoepithelioma-like carcinoma of lung. J Surg Oncol, 1987, 36(4): 280-283.
3.	Huang CJ, Feng AC, Fang YF, et al. Multimodality treatment and long-term follow-up of the primary pulmonary lymphoepithelioma-like carcinoma. Clin Lung Cancer, 2012, 13(5): 359-362.
4.	Chang YL, Wu CT, Shih JY, et al. New aspects in clinicopathologic and oncogene studies of 23 pulmonary lymphoepithelioma-like carcinomas. Am J Surg Pathol, 2002, 26(6): 715-723.
5.	Butler AE, Colby TV, Weiss L, et al. Lymphoepithelioma-like carcinoma of the lung. Am J Surg Pathol, 1989, 13(8): 632-639.
6.	Chen FF, Yan JJ, Lai WW, et al. Epstein-Barr virus-associated nonsmall cell lung carcinoma: undifferentiated "lymphoepithelioma-like" carcinoma as a distinct entity with better prognosis. Cancer, 1998, 82(12): 2334-2342.
7.	Jiang WY, Wang R, Pan XF, et al. Clinicopathological features and prognosis of primary pulmonary lymphoepithelioma-like carcinoma. J Thorac Dis, 2016, 8(9): 2610-2616.
8.	Liang Y, Wang L, Zhu Y, et al. Primary pulmonary lymphoepithelioma-like carcinoma: fifty-two patients with long-term follow-up. Cancer, 2012, 118(19): 4748-4758.
9.	Sun YH, Lin SW, Hsieh CC, et al. Treatment outcomes of patients with different subtypes of large cell carcinoma of the lung. Ann Thorac Surg, 2014, 98(3): 1013-1019.
10.	Huang CJ, Chan KY, Lee MY, et al. Computed tomography characteristics of primary pulmonary lymphoepithelioma-like carcinoma. Br J Radiol, 2007, 80(958): 803-806.
11.	Curcio LD, Cohen JS, Grannis FW Jr, et al. Primary lymphoepithelioma-like carcinoma of the lung in a child. Report of an Epstein-Barr virus-related neoplasm. Chest, 1997, 111(1): 250-251.
12.	Mo Y, Shen J, Zhang Y, et al. Primary lymphoepithelioma-like carcinoma of the lung: distinct computed tomography features and associated clinical outcomes. J Thorac Imaging, 2014, 29(4): 246-251.
13.	Grimes BS, Albores J, Barjaktarevic I. A 65-year-old man with persistent cough and large nodular opacity. Chest, 2015, 147(1): e13-e17.
14.	Xie M, Wu X, Wang F, et al. Clinical significance of plasma Epstein-Barr virus DNA in pulmonary lymphoepithelioma-like carcinoma (LELC) patients. J Thorac Oncol, 2018, 13(2): 218-227.
15.	Castro CY, Ostrowski ML, Barrios R, et al. Relationship between Epstein-Barr virus and lymphoepithelioma-like carcinoma of the lung: a clinicopathologic study of 6 cases and review of the literature. Hum Pathol, 2001, 32(8): 863-872.
16.	Ma H, Wu Y, Lin Y, et al. Computed tomography characteristics of primary pulmonary lymphoepithelioma-like carcinoma in 41 patients. Eur J Radiol, 2013, 82(8): 1343-1346.
17.	鲍军芳, 魏新华, 江新青. 原发性肺淋巴上皮瘤样癌的 CT 表现: 附 14 例报告及文献复习. 中国 CT 和 MRI 杂志, 2016, 14(11): 60-62.
18.	梁辉清, 曾庆思, 袁国奇, 等. 原发性肺淋巴上皮瘤样癌的 CT 表现. 中国医学影像技术, 2014, 30(8): 1203-1206.
19.	Hsieh MS, Wu CT, Chang YL. Unusual presentation of lymphoepithelioma-like carcinoma of lung as a thin-walled cavity. Ann Thorac Surg, 2013, 96(5): 1857-1859.
20.	Maruyama H, Tokitsu K, Orino T, et al. Histological variant of lung cancer: Two cases of a 7 mm lymphoepithelioma-like carcinoma and a small adenocarcinoma with lymphangiosis carcinomatosa. Histopathology, 2010, 57(Suppl 1): 231.
21.	彭大云, 廖秋林, 陈晓东, 等. 肺原发淋巴上皮样癌 18 例临床病理研究. 中国临床研究, 2017, 30(4): 467-470.
22.	Anand A, Zayac A, Curtiss C, et al. Pulmonary lymphoepithelioma-like carcinoma disguised as squamous cell carcinoma. J Thorac Oncol, 2018, 13(5): e75-e76.
23.	Qin Y, Gao G, Xie X, et al. Clinical features and prognosis of pulmonary lymphoepithelioma-like carcinoma: summary of eighty-five cases. Clin Lung Cancer, 2018, 20(3): e329-e337.
24.	Liang Y, Wang L, Lin Y, et al. Detection of ALK rearrangement and EGFR mutation in primary pulmonary lymphoepithelioma-like carcinoma. J Thorac Oncol, 2015, 10(9 Suppl 2): S308.
25.	Ho JC, Wong MP, Lam WK. Lymphoepithelioma-like carcinoma of the lung. Respirology, 2006, 11(5): 539-545.
26.	Ngan RK, Yip TT, Cheng WW, et al. Circulating Epstein-Barr virus DNA in serum of patients with lymphoepithelioma-like carcinoma of the lung: a potential surrogate marker for monitoring disease. Clin Cancer Res, 2002, 8(4): 986-994.
27.	Lin CY, Chen YJ, Hsieh MH, et al. Advanced primary pulmonary lymphoepithelioma-like carcinoma: clinical manifestations, treatment, and outcome. J Thorac Dis, 2017, 9(1): 123-128.
28.	Hekelaar N, van Uffelen R, van Vliet AC, et al. Primary lymphoepithelioma-like carcinoma within an intralobular pulmonary sequestration. Eur Respir J, 2000, 16(5): 1025-1027.
29.	Liu TC, Chen IS, Lin TK, et al. Erythema elevatum diutinum as a paraneoplastic syndrome in a patient with pulmonary lymphoepithelioma-like carcinoma. Lung Cancer, 2009, 63(1): 151-153.
30.	Feng WH, Hong G, Delecluse HJ, et al. Lytic induction therapy for Epstein-Barr virus-positive B-cell lymphomas. J Virol, 2004, 78(4): 1893-1902.
31.	Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med, 2015, 373(17): 1627-1639.
32.	Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med, 2015, 373(2): 123-135.
33.	Vokes EE, Ready N, Felip E, et al. Nivolumab versus docetaxel in previously treated advanced non-small-cell lung cancer (CheckMate 017 and CheckMate 057): 3-year update and outcomes in patients with liver metastases. Ann Oncol, 2018, 29(4): 959-965.
34.	Jiang L, Wang L, Li PF, et al. Positive expression of programmed death ligand-1 correlates with superior outcomes and might be a therapeutic target in primary pulmonary lymphoepithelioma-like carcinoma. Onco Targets Ther, 2015, 8: 1451-1457.
35.	Fang W, Hong S, Chen N, et al. PD-L1 is remarkably over-expressed in EBV-associated pulmonary lymphoepithelioma-like carcinoma and related to poor disease-free survival. Oncotarget, 2015, 6(32): 33019-33032.
36.	Kumar V, Dave V, Harris J, et al. Response of advanced stage recurrent lymphoepithelioma-like carcinoma to nivolumab. Immunotherapy, 2017, 9(12): 955-961.
37.	Narayanan A, Knollmann FD, Walby JAS, et al. EBV-positive primary pulmonary lymphoepithelioma-like carcinoma response to PD-L1 blockade. Clin Lung Cancer, 2018,20(3):e238-e241.
38.	Wang L, Long W, Li PF, et al. An elevated peripheral blood monocyte-to-lymphocyte ratio predicts poor prognosis in patients with primary pulmonary lymphoepithelioma-like carcinoma. PLoS One, 2015, 10(5): e0126269.

1. He J, Shen J, Pan H, et al. Pulmonary lymphoepithelioma-like carcinoma: a surveillance, epidemiology, and end results database analysis. J Thorac Dis, 2015, 7(12): 2330-2338.
2. Bégin LR, Eskandari J, Joncas J, et al. Epstein-Barr virus related lymphoepithelioma-like carcinoma of lung. J Surg Oncol, 1987, 36(4): 280-283.
3. Huang CJ, Feng AC, Fang YF, et al. Multimodality treatment and long-term follow-up of the primary pulmonary lymphoepithelioma-like carcinoma. Clin Lung Cancer, 2012, 13(5): 359-362.
4. Chang YL, Wu CT, Shih JY, et al. New aspects in clinicopathologic and oncogene studies of 23 pulmonary lymphoepithelioma-like carcinomas. Am J Surg Pathol, 2002, 26(6): 715-723.
5. Butler AE, Colby TV, Weiss L, et al. Lymphoepithelioma-like carcinoma of the lung. Am J Surg Pathol, 1989, 13(8): 632-639.
6. Chen FF, Yan JJ, Lai WW, et al. Epstein-Barr virus-associated nonsmall cell lung carcinoma: undifferentiated "lymphoepithelioma-like" carcinoma as a distinct entity with better prognosis. Cancer, 1998, 82(12): 2334-2342.
7. Jiang WY, Wang R, Pan XF, et al. Clinicopathological features and prognosis of primary pulmonary lymphoepithelioma-like carcinoma. J Thorac Dis, 2016, 8(9): 2610-2616.
8. Liang Y, Wang L, Zhu Y, et al. Primary pulmonary lymphoepithelioma-like carcinoma: fifty-two patients with long-term follow-up. Cancer, 2012, 118(19): 4748-4758.
9. Sun YH, Lin SW, Hsieh CC, et al. Treatment outcomes of patients with different subtypes of large cell carcinoma of the lung. Ann Thorac Surg, 2014, 98(3): 1013-1019.
10. Huang CJ, Chan KY, Lee MY, et al. Computed tomography characteristics of primary pulmonary lymphoepithelioma-like carcinoma. Br J Radiol, 2007, 80(958): 803-806.
11. Curcio LD, Cohen JS, Grannis FW Jr, et al. Primary lymphoepithelioma-like carcinoma of the lung in a child. Report of an Epstein-Barr virus-related neoplasm. Chest, 1997, 111(1): 250-251.
12. Mo Y, Shen J, Zhang Y, et al. Primary lymphoepithelioma-like carcinoma of the lung: distinct computed tomography features and associated clinical outcomes. J Thorac Imaging, 2014, 29(4): 246-251.
13. Grimes BS, Albores J, Barjaktarevic I. A 65-year-old man with persistent cough and large nodular opacity. Chest, 2015, 147(1): e13-e17.
14. Xie M, Wu X, Wang F, et al. Clinical significance of plasma Epstein-Barr virus DNA in pulmonary lymphoepithelioma-like carcinoma (LELC) patients. J Thorac Oncol, 2018, 13(2): 218-227.
15. Castro CY, Ostrowski ML, Barrios R, et al. Relationship between Epstein-Barr virus and lymphoepithelioma-like carcinoma of the lung: a clinicopathologic study of 6 cases and review of the literature. Hum Pathol, 2001, 32(8): 863-872.
16. Ma H, Wu Y, Lin Y, et al. Computed tomography characteristics of primary pulmonary lymphoepithelioma-like carcinoma in 41 patients. Eur J Radiol, 2013, 82(8): 1343-1346.
17. 鲍军芳, 魏新华, 江新青. 原发性肺淋巴上皮瘤样癌的 CT 表现: 附 14 例报告及文献复习. 中国 CT 和 MRI 杂志, 2016, 14(11): 60-62.
18. 梁辉清, 曾庆思, 袁国奇, 等. 原发性肺淋巴上皮瘤样癌的 CT 表现. 中国医学影像技术, 2014, 30(8): 1203-1206.
19. Hsieh MS, Wu CT, Chang YL. Unusual presentation of lymphoepithelioma-like carcinoma of lung as a thin-walled cavity. Ann Thorac Surg, 2013, 96(5): 1857-1859.
20. Maruyama H, Tokitsu K, Orino T, et al. Histological variant of lung cancer: Two cases of a 7 mm lymphoepithelioma-like carcinoma and a small adenocarcinoma with lymphangiosis carcinomatosa. Histopathology, 2010, 57(Suppl 1): 231.
21. 彭大云, 廖秋林, 陈晓东, 等. 肺原发淋巴上皮样癌 18 例临床病理研究. 中国临床研究, 2017, 30(4): 467-470.
22. Anand A, Zayac A, Curtiss C, et al. Pulmonary lymphoepithelioma-like carcinoma disguised as squamous cell carcinoma. J Thorac Oncol, 2018, 13(5): e75-e76.
23. Qin Y, Gao G, Xie X, et al. Clinical features and prognosis of pulmonary lymphoepithelioma-like carcinoma: summary of eighty-five cases. Clin Lung Cancer, 2018, 20(3): e329-e337.
24. Liang Y, Wang L, Lin Y, et al. Detection of ALK rearrangement and EGFR mutation in primary pulmonary lymphoepithelioma-like carcinoma. J Thorac Oncol, 2015, 10(9 Suppl 2): S308.
25. Ho JC, Wong MP, Lam WK. Lymphoepithelioma-like carcinoma of the lung. Respirology, 2006, 11(5): 539-545.
26. Ngan RK, Yip TT, Cheng WW, et al. Circulating Epstein-Barr virus DNA in serum of patients with lymphoepithelioma-like carcinoma of the lung: a potential surrogate marker for monitoring disease. Clin Cancer Res, 2002, 8(4): 986-994.
27. Lin CY, Chen YJ, Hsieh MH, et al. Advanced primary pulmonary lymphoepithelioma-like carcinoma: clinical manifestations, treatment, and outcome. J Thorac Dis, 2017, 9(1): 123-128.
28. Hekelaar N, van Uffelen R, van Vliet AC, et al. Primary lymphoepithelioma-like carcinoma within an intralobular pulmonary sequestration. Eur Respir J, 2000, 16(5): 1025-1027.
29. Liu TC, Chen IS, Lin TK, et al. Erythema elevatum diutinum as a paraneoplastic syndrome in a patient with pulmonary lymphoepithelioma-like carcinoma. Lung Cancer, 2009, 63(1): 151-153.
30. Feng WH, Hong G, Delecluse HJ, et al. Lytic induction therapy for Epstein-Barr virus-positive B-cell lymphomas. J Virol, 2004, 78(4): 1893-1902.
31. Borghaei H, Paz-Ares L, Horn L, et al. Nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. N Engl J Med, 2015, 373(17): 1627-1639.
32. Brahmer J, Reckamp KL, Baas P, et al. Nivolumab versus docetaxel in advanced squamous-cell non-small-cell lung cancer. N Engl J Med, 2015, 373(2): 123-135.
33. Vokes EE, Ready N, Felip E, et al. Nivolumab versus docetaxel in previously treated advanced non-small-cell lung cancer (CheckMate 017 and CheckMate 057): 3-year update and outcomes in patients with liver metastases. Ann Oncol, 2018, 29(4): 959-965.
34. Jiang L, Wang L, Li PF, et al. Positive expression of programmed death ligand-1 correlates with superior outcomes and might be a therapeutic target in primary pulmonary lymphoepithelioma-like carcinoma. Onco Targets Ther, 2015, 8: 1451-1457.
35. Fang W, Hong S, Chen N, et al. PD-L1 is remarkably over-expressed in EBV-associated pulmonary lymphoepithelioma-like carcinoma and related to poor disease-free survival. Oncotarget, 2015, 6(32): 33019-33032.
36. Kumar V, Dave V, Harris J, et al. Response of advanced stage recurrent lymphoepithelioma-like carcinoma to nivolumab. Immunotherapy, 2017, 9(12): 955-961.
37. Narayanan A, Knollmann FD, Walby JAS, et al. EBV-positive primary pulmonary lymphoepithelioma-like carcinoma response to PD-L1 blockade. Clin Lung Cancer, 2018,20(3):e238-e241.
38. Wang L, Long W, Li PF, et al. An elevated peripheral blood monocyte-to-lymphocyte ratio predicts poor prognosis in patients with primary pulmonary lymphoepithelioma-like carcinoma. PLoS One, 2015, 10(5): e0126269.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical research progress of primary pulmonary lymphoepithelioma-like carcinoma

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