Chest Disease Diagnosis and Treatment Center, Zhejiang Rongjun Hospital, Jiaxing, China.
Department of Pathology, Tongji University Affiliated Shanghai East Hospital, Shanghai, China.
Thorac Cancer. 2018 Jul;9(7):881-884. doi: 10.1111/1759-7714.12648. Epub 2018 May 8.
ALK rearrangement is a driver gene in non-small cell lung cancer (NSCLC). ALK-positive tumors are sensitive to ALK-tyrosine kinase inhibitors (TKIs). The detection of key driver genes is crucial to enable personalized treatment. Different histomorphological patterns have different driver genes. Herein, we report the case of a 42-year-old male patient diagnosed with adenocarcinoma with different histomorphologies in the primary lung site (mucinous type) and lymph node metastasis (solid type), of the same genotype, both presenting with ALK rearrangement but negative for EGFR mutation. This histological heterogeneity did not necessarily indicate a genomic difference. Genomic analysis may be a supplement to the histological features of ALK-rearranged tumors. These gene alterations could aid the choice of an appropriate TKI and predict therapeutic response.
ALK 重排是一种非小细胞肺癌（NSCLC）的驱动基因。ALK 阳性肿瘤对 ALK 酪氨酸激酶抑制剂（TKI）敏感。检测关键驱动基因对于实现个体化治疗至关重要。不同的组织形态学模式具有不同的驱动基因。在此，我们报告了一例 42 岁男性患者，其原发性肺部（黏液型）和淋巴结转移（实体型）部位的腺癌具有不同的组织形态学，基因型相同，均表现为 ALK 重排，但 EGFR 突变阴性。这种组织学异质性并不一定表明存在基因组差异。基因组分析可能是 ALK 重排肿瘤组织学特征的补充。这些基因改变可以帮助选择合适的 TKI 并预测治疗反应。
