Yanagitani Noriko, Horiike Atsushi, Kudo Keita, Ohyanagi Fumiyoshi, Nishio Makoto, Horai Takeshi
Japanese Foundation for Cancer Research, Thoracic Oncology Center.
Nihon Kokyuki Gakkai Zasshi. 2011 Apr;49(4):282-6.
A 56-year-old man was admitted, and was given a diagnosis of adenocarcinoma of the lung (T2N0M0, clinical stage IB), but pleural dissemination was found during surgery. A computed tomography (CT) scan 10 months after surgery revealed enlargement of the mediastinal lymph nodes and a thrombus in the pulmonary artery. Although the patient was immediately given warfarin and heparin, the warfarin was discontinued due to liver dysfunction, and the thromboembolism in his pulmonary artery recurred. The epidermal growth factor receptor (EGFR) mutation investigation of the surgical specimen revealed an EGFR point mutation at exon 21 (L858R). Gefitinib treatment was started and his levels of plasma D-dimer immediately decreased. The mediastinal lymph nodes shrank, and the thrombus in the pulmonary artery had disappeared on a CT scan 2 months after gefitinib treatment. Tumor regression was observed, and no recurrence of the pulmonary embolism was found 10 months after gefitinib treatment. Gefitinib was therefore a very effective treatment not only for lung cancer, but also for pulmonary embolism due to lung cancer.
一名56岁男性入院，被诊断为肺癌（T2N0M0，临床分期IB），但手术中发现有胸膜播散。术后10个月的计算机断层扫描（CT）显示纵隔淋巴结肿大及肺动脉血栓形成。尽管患者立即接受了华法林和肝素治疗，但因肝功能障碍停用了华法林，其肺动脉血栓栓塞复发。手术标本的表皮生长因子受体（EGFR）突变检测显示第21外显子存在EGFR点突变（L858R）。开始吉非替尼治疗后，患者血浆D-二聚体水平立即下降。纵隔淋巴结缩小，吉非替尼治疗2个月后的CT扫描显示肺动脉血栓消失。观察到肿瘤退缩，吉非替尼治疗10个月后未发现肺栓塞复发。因此，吉非替尼不仅对肺癌非常有效，而且对肺癌所致的肺栓塞也非常有效。
