Lymphoepithelioma-like carcinoma of the uterine cervix: correlation with Epstein-Barr virus and human papillomavirus infection. A single-center experience

Background and objectives: Lymphoepithelioma-like carcinoma of the uterine cervix (LELC) is a rare subtype of the squamous cell carcinoma with unclear viral carcinogenesis and prognosis. Aim: We aimed to investigate the status of HPV and EBV infection in a cohort of Caucasian women with LELC of the uterine cervix and to compare the results on prevalence, association with both viruses and methods of detection in this disease with the results of other studies. Materials and methods: We retrospectively evaluated all patients with LELC, diagnosed and treated at Department of Gynaecologic Oncology, Medical University Pleven, Bulgaria between 2008 and 2015. The status of infection with HPV and EBV was investigated on tumor tissue by polymerase chain reaction (PCR) and in situ hybridization (ISH). We compare the results with the results from a systematic search of the literature on this topic. Results: LELCs represented 3.03% (16 patients) of all stage I cervical carcinoma cases. Infection with HPV and EBV was investigated in 50% (8) of them. ISH and PCR testing detected HPV in 37.5% (3) and 50% (4) of the patients; EBV in 12.5% (1) and 75% (6). No cases of co-infection were found with ISH and 4 with PCR. In the literature are reported 98 cases of this disease and infection with EBV is found in 25.7% the tested patients. Conclusion: HPV and EBV strains and a co-infection of the two viruses are possible factors in genesis of LELC of the uterine cervix. Our data suggests that infection with EBV could be more common in Caucasians women with LELC, than previously reported.

Cervical cancer; Lymphoepithelioma-like carcinoma; Epstein-Barr virus; Human papillomavirus; In situ hybridization; Polymerase chain reaction.

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