尿路上皮淋巴上皮瘤样癌16例临床病理分析OA

Objective To investigate the clinicopathological features and prognosis of lymphoepithelioma-like urothelial carcinoma(LELUC),so as to deepen the recognition of this tumor and optimize its diagnosis and treatment regimens.Methods Clinicopathological data of 16 patients diagnosed with LELUC were collected.EnVision immuno-histochemical staining and next-generation sequencing(NGS)were performed,followed by patient follow-up and a sys-tematic review of relevant literature.Results LELUC arose in the upper urinary tract and bladder,with a key histo-logical characteristic of prominent stromal lymphocyte infiltration.Immunohistochemistry showed basal-like differentia-tion in 62.5%(10/16)of the tumors.Tumors exhibited high expression of PD-L1,with a tumor proportion score(TPS)of 10%-80%and a combined positive score(CPS)of 20-100.Among them,62.5%(10/16)of the cases had a CPS of≥50.In addition,mutant-type p53 positivity was observed in 87.5%(14/16)of cases,and all cases demon-strated intact expression of mismatch repair(MMR)proteins.NGS testing of 2 cases with upper urinary tract LELUC identified TP53 mutations in both cases,with tumor mutation burden(TMB)of 3.0 mut/Mb and 13.0 mut/Mb,re-spectively.During a follow-up of 4-90 months,only 2 cases developed tumor recurrence,and no tumor-related death occurred.Conclusion LELUC exhibits distinctive histopathological features,immunophenotypic profiles,and mo-lecular genetic alterations.Conventional treatment combined with immune checkpoint inhibitors may improve the prog-nosis of patients with LELUC.