Chou Chiung-Tung, Ou Chun-Yen, Lee Wei-Ting, Hsu Heng-Jui
Department of Otolaryngology National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan Taiwan.
Laryngoscope Investig Otolaryngol. 2022 May 9;7(3):779-784. doi: 10.1002/lio2.811. eCollection 2022 Jun.
Lymphoepithelial carcinoma (LEC) accounts for 0.4% of malignant tumors of the salivary gland and 0.8% of parotid gland malignancies. Over the past 50 years, less than 300 cases have been reported in the literature. The purpose of this study was to investigate the characteristics of salivary gland LEC.
We retrospectively reviewed the medical records and analyzed clinical data obtained from 10 patients seen at our hospital between 2005 and 2020 with salivary gland LEC.
All patients presented with a self-palpable, non-tender, hard swelling, or lump near the jaw or infra-auricular region. Most cases ( = 8) were of solitary tumors, and enhancing patterns on computed tomography mainly were homogenous ( = 8). Interestingly, eight patients tested positive for the Epstein-Barr encoding region in in situ hybridization. Still, only three patients had detectable circulating Epstein-Barr virus (EBV) DNA, and one patient had detectable EBV IgA. All patients underwent complete tumor resection, followed by radiotherapy, and six also underwent chemotherapy. Nine patients became disease-free within 5 years, and one died due to disease 4 years after surgery.
Although rare and considered to be a high-risk malignancy, LECs have favorable treatment outcomes. Circulating EBV DNA is still not considered a marker for preoperative assessment or postoperative treatment response. The role of EBV DNA requires further investigation.Level of Evidence: 4.
淋巴上皮癌（LEC）占涎腺恶性肿瘤的0.4%，占腮腺恶性肿瘤的0.8%。在过去50年里，文献报道的病例不到300例。本研究的目的是探讨涎腺LEC的特征。
我们回顾性分析了2005年至2020年间在我院就诊的10例涎腺LEC患者的病历，并分析了其临床资料。
所有患者均在颌部或耳下区域出现可自行触及的、无压痛的硬性肿胀或肿块。大多数病例（n = 8）为单发肿瘤，计算机断层扫描增强模式主要为均匀增强（n = 8）。有趣的是，8例患者原位杂交检测爱泼斯坦-巴尔编码区呈阳性。然而，只有3例患者检测到循环爱泼斯坦-巴尔病毒（EBV）DNA，1例患者检测到EBV IgA。所有患者均接受了肿瘤全切术，随后进行放疗，6例患者还接受了化疗。9例患者在5年内无病生存，1例患者术后4年因疾病死亡。
尽管LEC罕见且被认为是一种高危恶性肿瘤，但治疗效果良好。循环EBV DNA仍不被视为术前评估或术后治疗反应的标志物。EBV DNA的作用需要进一步研究。证据水平：4级。
