与其他肺鳞状细胞癌（LUSC）相比，肺淋巴上皮样癌（pLELC）与EB病毒感染密切相关，具有独特的分子特征和免疫微环境。为了比较pLELC和LUSC之间的治疗反应和免疫治疗效果，本研究旨在招募中国三家医院的31名pLELC患者和116名LUSC患者，接受一线免疫治疗，并比较了两组的治疗反应和免疫治疗效果。使用倾向评分匹配（PSM）来平衡两组之间基线数据的差异。在PSM之前，与LUSC组相比，pLELC组的无进展生存期和总生存期更长（无进展生存期：危险比（HR）为1.67，95% CI：1.05-2.63，P = 0.028；总生存期：HR为1.90，95% CI：1.06-3.40，P = 0.028）。在PSM之后，这种差异没有改变（无进展生存期：HR为1.79，95% CI：1.02-3.15，P = 0.044；总生存期：HR为2.20，95% CI：1.10-4.37，P = 0.022）。pLELC在免疫治疗后显示出与传统LUSC相比的临床意义上的生存优势。随后的研究应考虑EB病毒在pLELC肿瘤免疫微环境中的作用。

Compared with other lung squamous cell carcinomas (LUSC), pulmonary lymphoepithelioma-like carcinoma (pLELC) is closely associated with Epstein-Barr virus (EBV) infections with a unique molecular profile and immune microenvironment. This study was thus established to compare the treatment response and effectiveness of immunotherapy between pLELC and LUSC.We enrolled 31 patients with pLELC and 116 with LUSC receiving first-line immunotherapy at three centers in China and compared the treatment response and effectiveness of immunotherapy. Propensity score matching (PSM) was used to balance the differences in baseline data between the two groups.Before PSM, progression-free survival and overall survival were longer in the pLELC group than in the LUSC group (progression-free survival: hazard ratio (HR), 1.67, 95% CI: 1.05-2.63, P = 0.028; overall survival: HR, 1.90, 95% CI: 1.06-3.40, P = 0.028). This remained unchanged after PSM (progression-free survival: HR, 1.79, 95% CI: 1.02-3.15, P = 0.044; overall survival: HR, 2.20; 95% CI: 1.10-4.37, P = 0.022).pLELC showed a clinically meaningful survival benefit compared with traditional LUSC following immunotherapy. Subsequent studies should consider the role of the EBV in the tumor immune microenvironment of pLELC.