Clinicopathological characteristics and cancer-specific prognosis of primary pulmonary lymphoepithelioma-like carcinoma: a population study of the US SEER database and a Chinese hospital.
Clinicopathological characteristics and cancer-specific prognosis of primary pulmonary lymphoepithelioma-like carcinoma: a population study of the US SEER database and a Chinese hospital.
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DOI：
10.3389/fonc.2023.1103169
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发表时间：
2023
影响因子：
4.7
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中科院分区：
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原发性肺淋巴上皮瘤样癌（PPLELC）是一种罕见的非小细胞肺癌（NSCLC）组织学类型，占NSCLC的不到1%。目前，PPLELC尚无公认的治疗指南。我们从2000年至2015年的监测、流行病学和最终结果（SEER）数据集中（n = 72）以及2014年至2020年的医疗中心（n = 16）确定了PPLELC患者。所有诊断均经病理检查证实，并检索和总结患者的临床病理特征。使用Kaplan-Meier分析和对数秩检验进行生存分析。采用考克斯回归风险模型进行多因素生存分析。PPLELC队列诊断时的中位年龄为64岁，范围为15 - 86岁。TNM分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期分别为52.3%、10.2%、20.5%、17.0%。88例患者中，69例（78.4%）进行了病灶切除，16例（18.1%）接受了放疗，40例（45.5%）接受了化疗。在肺癌SEER数据集中，亚洲人种的PPLELC百分比（0.528‰）几乎是白色人种（0.065‰）和黑人（0.056‰）的10倍。TNM分期III-IV期患者的预后比TNM分期I-II期患者差（p = 0.008），TNM分期I-II期的5年癌症特异性生存率（CSS）为81.8%，TNM分期III-IV期为56.2%。具体而言，N分期和M分期是主要的预后因素，而不是T分期和肿瘤大小。此外，接受手术的患者的结局明显优于未接受手术的患者（p = 0.014）。多因素分析显示TNM分期是CSS的独立预后因素（HR，3.31; 95%CI，1.08-10.14）。PPLELC是一种罕见的肿瘤，具有亚洲易感性。虽然PPLELC的预后优于其他亚型的NSCLC，但对于晚期疾病仍不令人满意。PPLELC目前的治疗选择包括手术切除、化疗、放疗和免疫治疗。在这些选择中，手术切除的患者在本研究中具有更好的生存率。然而，大规模的临床研究试验将是必要的，以制定有效的PPLELC治疗指南。
Primary pulmonary lymphoepithelioma-like carcinoma (PPLELC) is a rare histological type of non-small cell lung cancer (NSCLC), which accounts for less than 1% of NSCLC. Currently, there is no well-recognized treatment guideline for PPLELC. We identified PPLELC patients from the Surveillance, Epidemiology, and End Results (SEER) dataset between 2000 and 2015 (n = 72) as well as from our medical center between 2014 and 2020 (n = 16). All diagnoses were confirmed by pathological testing, and the clinicopathological characteristics of patients were retrieved and summarized. Survival analyses were conducted using the Kaplan–Meier analysis and log-rank tests. Multivariate survival analysis was performed with the Cox regression hazards model. The median age at diagnosis of the PPLELC cohort was 64 years, ranging from 15 to 86 years. The percentages of patients with TNM stages I, II, III, and IV were 52.3%, 10.2%, 20.5%, and 17.0%, respectively. Among the 88 cases, lesion resection was performed in 69 cases (78.4%), 16 cases (18.1%) received beam radiation, and 40 cases (45.5%) underwent chemotherapy. In the SEER dataset of lung cancer, the percentage of PPLELC in the Asian race (0.528‰) was almost 10 times higher than that in the white (0.065‰) and black (0.056‰) races. Patients with TNM stage III–IV exhibited a worse prognosis than those with TNM stage I–II (p = 0.008), with a 5-year cancer-specific survival (CSS) rate of 81.8% for TNM stage I–II and 56.2% for TNM stage III–IV. Specifically, the N stage and M stage were the leading prognostic factors, not the T stage and tumor size. Moreover, patients who underwent surgery had significantly better outcomes than those who did not (p = 0.014). Additional multivariate analysis indicated that the TNM stage was an independent prognosis factor for CSS (HR, 3.31; 95% CI, 1.08–10.14). PPLELC is a rare tumor with Asian susceptibility. Although the prognosis of PPLELC is better than that of other subtypes of NSCLC, it remains unsatisfactory for advanced-stage disease. The current treatment options for PPLELC include surgical resection, chemotherapy, radiotherapy, and immune therapy. Among these options, patients with surgical resection have better survival rates in this study. However, large-scale clinical research trials will be necessary to develop effective treatment guidelines for PPLELC.
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影响因子：
3.7
作者：
Tang L;Chen N;He W;Zhou J;Zhang J;Lin Z;Wang Z;Hao J;Lin F
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Chen, Xi
影响因子：
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