Deng Huiyan, Liu Chang, Zhang Guoliang, Wang Xiaoling, Liu Yueping
Department of Pathology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China.
Department of Chest surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China.
Pathol Res Pract. 2018 Dec;214(12):2103-2105. doi: 10.1016/j.prp.2018.09.028. Epub 2018 Oct 1.
ALK and ROS1 are prognostic and predictive tumor markers in non-small cell lung carcinoma (NSCLC), which are more often found in lung adenocarcinomas as with other oncogenes such as EGFR, KRAS, or C-MET. Their positivity is 2.6% and 1.3%, respectively, and patients who have mutations in both genes are extremely rare. Here, we report a 61-year-old male diagnosed with acinar adenocarcinoma, who was shown to have both ALK and ROS1 rearrangements but was EGFR- and C-MET mutation-negative. He was treated surgically and received targeted therapy. Our review of the literature revealed that few such cases of concurrent ALK and ROS1 rearrangements have been reported. This information furthers our understanding of the molecular biology underlying NSCLC which will aid the selection of optimal treatment for patients with more than one driver mutation.
间变性淋巴瘤激酶（ALK）和ROS1是非小细胞肺癌（NSCLC）中的预后和预测性肿瘤标志物，与其他致癌基因如表皮生长因子受体（EGFR）、 Kirsten大鼠肉瘤病毒癌基因（KRAS）或间质上皮转化因子（C-MET）一样，它们在肺腺癌中更常见。它们的阳性率分别为2.6%和1.3%，同时具有这两种基因变异的患者极为罕见。在此，我们报告一名61岁男性，诊断为腺泡腺癌，检测显示其同时存在ALK和ROS1重排，但EGFR和C-MET突变阴性。他接受了手术治疗并接受了靶向治疗。我们对文献的回顾发现，很少有关于ALK和ROS1同时重排的病例报道。这些信息加深了我们对NSCLC分子生物学的理解，这将有助于为具有多种驱动基因突变的患者选择最佳治疗方案。
