Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC), Beijing 100021,China
AbstractObjective To analyze the clinical features,diagnosis and prognosis of patients with primary lymphoepithelial carcinoma of the parotid gland. Methods Clinical data of 13 patients diagnosed with lymphoepithelial carcinoma of the parotid gland in our hospital from 2009 to 2017 were retrospectively analyzed. The median follow-up time was 38.5 months. All patients received radiotherapy after operation. Results Of 13 patients,9 cases were male and 4 female. The median age was 33 years. At the initial diagnosis,9 cases had primary lesions limited to the parotid gland,and 4 cases of lymph node metastases located in Ⅰ b and Ⅱ regions of the neck. According to UICC2010 staging,1 case was classified as stage Ⅰ,1 as stage Ⅱ,6 as stage Ⅲ and 5 as stage Ⅳ, respectively. Eleven surgically pathological specimens were tested with EBER in-situ,and 10 cases were positive for EBER. No patient died in the whole group. The 3-year overall survival rate was 100%. The 3-year progression-free survival rate was 76%. The 3-year local control rate was 92%. The 3-year metastasis-free survival rate was 84%. Conclusions The incidence of lymphoepithelial carcinoma of the parotid gland is relatively low. The pathological features are associated with EB virus. It is prone to present with cervical lymph node metastasis. The possibility of lymph node metastasis of nasopharyngeal carcinoma to the parotid gland should be excluded before treatment. At present, surgery combined with postoperative radiotherapy is the main treatment. The overall survival is favorable. Local recurrence and distant metastasis are the main causes of treatment failure.
Wang Huili,Huang Xiaodong,Qu Yuan et al. Clinical characteristics,diagnosis and efficacy of primary lymphoepithelial carcinoma of the parotid gland[J]. Chinese Journal of Radiation Oncology, 2019, 28(9): 648-651.
Wang Huili,Huang Xiaodong,Qu Yuan et al. Clinical characteristics,diagnosis and efficacy of primary lymphoepithelial carcinoma of the parotid gland[J]. Chinese Journal of Radiation Oncology, 2019, 28(9): 648-651.
[1] Hamilton-Dutoit SJ,Therkildsen MH,Neilsen NH,et al. Undifferentiated carcinoma of the salivary gland in greenlandic eskimos:demonstration of Epstein-Barr virus DNA by in situ nucleic acid hybridization[J]. Human Pathol,1991,22(8):811-815. [2] 宗永生,刘克拉,饶慧兰,等. 腮腺淋巴上皮瘤样癌与EB病毒感染的关系[J]. 临床与实验病理学杂志,1999,15(5):377-381. [3] 陈彤箴. 唾腺淋巴上皮癌临床病理学及其与EB病毒相关性研究[D]. 上海:复旦大学,2003. [4] Abdelkrim SB,Trabelsi A,Hammedi F,et al. Primary lymphoepithelial carcinoma of the parotid gland in a North African woman[J]. Rare Tumors,2009,1(1):e16. DOI:10.4081/rt.2009.e16. [5] Manganaris A,Patakiouta F,Xirou P,et al. Lymphoepithelial carcinoma of the parotid gland:is an association with Epstein-Barr virus possible in non-endemic areas?[J]. Int J Oral Maxillofac Surg,2007,36(6):556-559. DOI:10.1016/j.ijom.2006.12.012. [6] Wu DL,Shemen L,Brady T,et al. Malignant lymphoepithelial lesion of the parotid gland:a case report and review of the literature[J]. Ear Nose Throat J,2001,80(11):803-806. DOI:10.1111/j.1442-2018.2007.00372.x. [7] Tsuchiya S. Diagnosis of Epstein-Barr virus-associated diseases[J]. Crit Rev Oncol/Hematology,2002,44(3):227-38. DOI:10.1016/S1040-8428(02)00114-2. [8] 李旭东,翦新春. 大涎腺淋巴上皮病的临床分析[J]. 口腔颌面外科杂志,2009,19(2):121-124. DOI:10.3969/j.issn.1005-4979.2009.02.014. [9] Wang HZ,Cao CN,Luo JW,et al. High-risk factors of parotid lymph node metastasis in nasopharyngeal carcinoma:a case-control study[J]. Radiati Oncol,2016,11(1):113. DOI:10.1016/j.ijrobp.2016.06.1550. [10] Schneider M,Rizzardi C. Lymphoepithelial carcinoma of the parotid glands and its relationship with benign lymphoepithelial lesions[J]. Arch Pathol Labor Med,2008,132(2):278-282. DOI:10.1043/1543-2165(2008)132[278:LCOTPG]2.0. CO;2. [11] Spencer CR,Skilbeck CJ,Thway K,et al. Lymphoepithelial carcinoma of the parotid gland:a rare neck lump[J]. Jrsm Short Rep,2012,3(5):28. DOI:10.1258/shorts.2012.011161. [12] Ellis G,Auclair P,Ellis GL,et al. Atlas of tumor pathology:tumors of the salivary glands[J]. Histopathology,1999,35(5):473-474. [13] 肖平,黄健男,张学辉,等. 腮腺淋巴上皮瘤样癌的诊断与治疗[J]. 临床耳鼻咽喉头颈外科杂志,2008,22(14):651-653. DOI:10.3969/j.issn.1001-1781.2008.14.010. [14] 吴静,林素暇,杨秋霞,等. 涎腺淋巴上皮样癌的影像表现[J]. 中华放射学杂志,2012,46(8):747-749. DOI:10.3760/cma.j.issn.1005-1201.2012.08.019. [15] Dubey P,Ha CS,Ang K K,et al. Nonnasopharyngeal lymphoepithelioma of the head and neck[J]. Cancer,2015,82(8):1556-1562. DOI:1 0.1002/(sici)1097-0142(19980415)82:8<1556::aid-cncr18>3.0.co;2-. [16] Li F,Zhu G,Wang Y,et al. A clinical analysis of 37 cases with lymphoepithelial carcinoma of the major salivary gland treated by surgical resection and postoperative radiotherapy:a single institution study[J]. Med Oncol,2014,31(5):957. DOI:10.1007/s12032-014-0957-9. [17] Zhan KY,Nicolli EA,Khaja SF,et al. Lymphoepithelial carcinoma of the major salivary glands:Predictors of survival in a non-endemic region[J]. Oral Oncol,2015,52:24-29. DOI:10.1016/j.oraloncology.2015.10.019. [18] 殷学敏,张磊涛,陈之锋,等.17例涎腺淋巴上皮癌临床病例分析[J]. 临床耳鼻咽喉头颈外科杂志,2013,27(21):1171-1174. [19] 蔡以理,王中和,陆顺娟. 手术联合放射治疗伴有淋巴样间质的未分化癌的疗效分析[J]. 上海口腔医学,2002,11(4):310-314. DOI:10.3969/j.issn.1006-7248.2002.04.008. [20] 张诠,卿菁,魏茂文,等. 涎腺淋巴上皮癌16例临床分析[J]. 癌症,2005,24(11):1384-1387. DOI:10.3969/j.issn.1000-467X.2005.11.018. [21] Barnes L,Eveson JW,Reichart P. World Health Organization classification of tumors:pathology and genetics of head and neck tumors[M]. Lyon:IARC,2005:251-252. [22] 吴兰雁. 涎腺淋巴上皮癌的临床病理及发病机理研究[D]. 成都:四川大学,2004. [23] 尼罗拉. 淋巴上皮瘤样癌在EB病毒流行地区的临床、病理和血清学分析[D]. 广州:中山大学,2007. [24] Ma H,Lin Y,Wang L,et al. Primary lymphoepithelioma-like carcinoma of salivary gland:sixty-nine cases with long-term follow-up[J]. Head Neck,2014,36(9):1305-1312. DOI:10.1002/hed.23450.
2019, Vol. 28 
