Epstein-Barr virus infection in Chinese salivary cancers

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In order to determine prevalence of Epstein-Barr virus (EBV) infection in salivary lymphoepitheliomas in China, we visited Taipei, Taichung, Chengdu, Urumqi, and Jinan, inaddition to the eight points where we had made expeditons previously and collected total 159 cases of this type of carcinomas and examined the tissue samples by immunohistochemistry, in-situ hybridization (ISH) for EBER-1 and polymerase chain reaction (PCR) technique for EBD DNA BamHI W region for the presence of EBV.The 159 cases of salivary lymphoepitheliomas were composed of 42 cases from Shanghai, 40, Chengdu ; 42, Guangzhou ; 9, Beijing ; 4, Wuhan ; 4, Changchun ; 3, Kunming ; 3, Xi'an ; 2, Urumqi ; 0, Jinan ; 6, Taipei ; and 3, Taichung. The high incidences were noted along the coast area. The figure from Chengdu seems to be related to frequent immigration from the South-West coast in the past. The lymphoepithelioma series consisted of 74 male and 78 female patients (9 unknown). Except for one Uygur and one Xibe, the patients were of Han race (3 unknown), ranging in age from 9 to 77 years (mean, 40.5 years ; 35% of patients were younger than 40 years). Its occurrence in the youngest generation was characteristic. More than half of the cases were located in parotid glands (69%), and 14% in minor salivary glands. Carcinoma cells of salivary lymphoepitheliomas were strongly immunopositive for EMA, CA15-3, and UEA-I binding, indicating their duct epithelial natures. Their cytoplasm was occasionaly immunopositive for LMP-1. The nuclei showed intense signals for EBER-1 by ISH in all of the cases examined. T-cells were predominant in the stroma. Positive PCR products were also shown in most of the cases. However, no EBV signals were obtained in the benign lymphoepithelial lesions.The results suggest that EBV and geographic factors play an important role in pathogenesis of the Chinese salivary lymphoepitheliomas.