对吉非替尼有不同反应的同步性多原发性肺癌。
Synchronous multiple primary lung cancers with different response to gefitinib.
作者信息
Ryoo Baek-Yeol, Na Im Il, Yang Sung Hyun, Koh Jae Soo, Kim Cheol Hyeon, Lee Jae Cheol
机构信息
Department of Internal Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Republic of Korea.
出版信息
Lung Cancer. 2006 Aug;53(2):245-8. doi: 10.1016/j.lungcan.2006.05.010. Epub 2006 Jun 19.
Synchronous bronchiolo-alveolar cell carcinoma (BAC) in both lungs and squamous cell carcinoma in left lung were found in a 66-year-old male smoker. After two courses of chemotherapy with gemcitabine and carboplatin, the left lung mass had partially resolved, however, the extent of BAC had been increased. When gefitinib was used as a second-line chemotherapy, the consolidation lesions of BAC was improved while the mass of squamous cell carcinoma was aggravated. The analysis of epidermal growth factor receptor-tyrosine kinase (EGFR-TK) mutations showed that BAC had the deletion, delE746-A750 in exon 19, however, squamous cell carcinoma had no mutations. These synchronous tumors with different location, histology, status of EGFR-TK mutations and response to chemotherapy might be caused by different molecular pathogenesis.
一名66岁男性吸烟者被发现双肺同时存在细支气管肺泡癌（BAC）以及左肺鳞状细胞癌。在接受了两疗程吉西他滨和顺铂化疗后，左肺肿块部分消退，然而，BAC的范围却增大了。当使用吉非替尼作为二线化疗药物时，BAC的巩固性病灶有所改善，而鳞状细胞癌的肿块却加重了。表皮生长因子受体 - 酪氨酸激酶（EGFR - TK）突变分析显示，BAC存在第19外显子的缺失，即delE746 - A750，然而鳞状细胞癌没有突变。这些具有不同位置、组织学类型、EGFR - TK突变状态及化疗反应的同步性肿瘤可能是由不同的分子发病机制引起的。
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