Intraoral salivary lymphoepithelial carcinoma: clinicopathologic and immunophenotypic characterization of 3 examples indicates consistently elevated PD-L1 expression

IF 1.9 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-07-21 DOI:10.1016/j.oooo.2025.04.054

Prokopios P. Argyris , Carter Lukenda , Emilian V. Racila , James Midtling , Mansur Ahmad , Rajaram Gopalakrishnan , Paul Freedman , Ioannis Koutlas

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引用次数: 0

Abstract

Introduction

Head/neck lymphoepithelial carcinoma (LEC) represents a morphologically undifferentiated carcinoma with associated, nonneoplastic, lymphoplasmacytic infiltration. LEC chiefly arises in the nasopharynx and major salivary glands (MSGs), primarily the parotid. Although there is approximately 80% 5-year survival rate, aggressive surgical resection may cause debilitating morbidity. Overexpression of the targetable immunotherapy marker PD-L1 was recently reported in MSG LEC and pulmonary lymphoepithelioma-like carcinoma. PD-L1 expression in intraoral salivary LEC (ISLEC) is vastly understudied.

Materials and Methods

Three examples of ISLEC diagnosed between 1985 and 2022 were retrieved from the archives of two oral and maxillofacial pathology laboratories. The specimens were immunohistochemically studied with antibodies against AE1/AE3, CK7, CD3, CD20, p16, p53, Ki67, and PD-L1 (SP263). EBER in situ hybridization (ISH) was also performed.

Results

All three cases affected men (age range = 42-84 years; median = 61 years), and involved the floor of mouth, soft palate/uvula, and tongue. Microscopically, the lesions were unencapsulated and showed diffuse infiltration by nonkeratinizing sheets and islands of undifferentiated carcinoma cells with associated dense lymphoplasmacytic inflammation. The overlying mucosal epithelium was unremarkable. By immunohistochemistry, all three tumors showed strong and diffuse AE1/AE3 positivity and selective p53 staining. CK7 and p16 were negative. Ki67 highlighted 20%-80% of lesional cells. The lymphocytic inflammatory infiltrate comprised of a mixed population of T and B lymphocytes. EBER ISH was positive in one case. Notably, all tumors displayed membranous, focal-to-diffuse, PD-L1 staining with tumor proportion score (TPS) > 95% in two and 40%-50% in the third case, and combined positive score (CPS) > 20.

Conclusions

ISLECs are rare. Overall, PD-L1 appears to be highly expressed in ISLEC, thus rendering such patients potential candidates for targeted α-PD-1/PD-L1 immunotherapy.

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口腔内唾液淋巴上皮癌：3例的临床病理和免疫表型特征表明PD-L1表达持续升高

头颈部淋巴上皮癌（LEC）是一种形态学上未分化的癌，伴有相关的非肿瘤性淋巴浆细胞浸润。LEC主要发生在鼻咽和大唾液腺（MSGs），主要是腮腺。虽然有大约80%的5年生存率，但积极的手术切除可能导致衰弱的发病率。靶向性免疫治疗标志物PD-L1在MSG LEC和肺淋巴上皮瘤样癌中的过表达最近被报道。PD-L1在口内唾液LEC （ISLEC）中的表达尚未得到充分研究。材料与方法从两所口腔颌面病理实验室1985 ~ 2022年诊断的ISLEC病例中检索3例。用抗AE1/AE3、CK7、CD3、CD20、p16、p53、Ki67和PD-L1 （SP263）抗体对标本进行免疫组织化学研究。同时进行了EBER原位杂交（ISH）。结果3例患者均为男性(年龄 = 42 ~ 84岁；中位 = 61岁)，涉及口腔底、软腭/小舌和舌头。镜下，病变未被包裹，呈弥漫性浸润，呈非角化片和未分化的癌细胞岛状浸润，伴致密淋巴浆细胞性炎症。上覆粘膜上皮无明显变化。经免疫组化检查，3例肿瘤均表现为强烈且弥漫性的AE1/AE3阳性和选择性p53染色。CK7、p16呈阴性。Ki67显示20%-80%的病变细胞。淋巴细胞炎性浸润由T淋巴细胞和B淋巴细胞混合组成。其中一例阳性。值得注意的是，所有肿瘤均呈膜性、局灶到弥漫性、PD-L1染色，肿瘤比例评分（TPS） >；2例95%，3例40% ~ 50%，合并阳性评分（CPS） >；20.。结论islecs少见。总的来说，PD-L1似乎在ISLEC中高度表达，从而使这些患者成为靶向α-PD-1/PD-L1免疫治疗的潜在候选人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.