Department of Respiratory and Critical Care Medicine, Northern Jiangsu People's Hospital, The First Clinical College of Dalian Medical University, Yangzhou 225001, Jiangsu, China.
Department of Respiratory and Critical Care Medicine, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou 225001, Jiangsu, China.
Lung Cancer. 2019 Nov;137:19-22. doi: 10.1016/j.lungcan.2019.08.032. Epub 2019 Aug 31.
Anaplastic lymphoma kinase (ALK) has been proven to be another driver oncogene that accounts for 3%-7% of non-small-cell lung cancer, and it is more common in young patients and nonsmokers. ALK rearrangements have been previously identified in about 5.1% of lung adenocarcinoma, including EML4-ALK fusion variants, KIF5B-ALK and TFG-ALK. However, a TNIP2-ALK fusion has not been reported in lung adenocarcinoma. Herein, we described a rare case of ALK-rearranged lung adenocarcinoma responding to crizotinib.
Immunohistochemistry (IHC) assay and comprehensive next-generation sequencing (NGS) were performed on the aspirated biopsied tumor tissue.
The IHC analysis revealed an ALK-positive tumor, while NGS detected a TNIP2-ALK fusion. The patient achieved continuous remission after treatment with crizotinib (250 mg, twice a day).
This case provides valuable information on the response to crizotinib of patients with TNIP2-ALK fusion and better understanding of ALK-TKI applications in the future. NGS is a new method that can offer effective detection of gene fusion and gene mutations.
间变性淋巴瘤激酶 (ALK) 已被证实为另一个驱动致癌基因，占非小细胞肺癌的 3%-7%，它在年轻患者和不吸烟者中更为常见。ALK 重排先前在约 5.1%的肺腺癌中被发现，包括 EML4-ALK 融合变体、KIF5B-ALK 和 TFG-ALK。然而，肺腺癌中尚未报道过 TNIP2-ALK 融合。在此，我们描述了一例罕见的对克唑替尼有反应的 ALK 重排肺腺癌病例。
对经抽吸活检的肿瘤组织进行免疫组织化学（IHC）检测和全面的下一代测序（NGS）。
IHC 分析显示肿瘤为 ALK 阳性，而 NGS 检测到 TNIP2-ALK 融合。患者接受克唑替尼（250mg，每日两次）治疗后持续缓解。
该病例为 TNIP2-ALK 融合患者对克唑替尼的反应提供了有价值的信息，并有助于更好地了解未来 ALK-TKI 的应用。NGS 是一种新的方法，可以有效地检测基因融合和基因突变。
