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食管鳞状细胞癌合并骨髓增生异常综合征/急性髓系白血病:一例报告并文献复习

Esophageal squamous cell cancer coincides with myelodysplastic syndrome/acute myelogenous leukemia: A case report and review of the literature.

作者信息

Liu Lingling, Liu Xiaoyun, Sun Yanling, Zeng Yinzhu, Tang Xiaoyun, Li Xiaoxia, Liu Jiajun, Xiao Ruozhi

机构信息

Department of Hematology, The Third Affiliated Hospital of Sun Yat-Sen University and Sun Yat-Sen Institute of Hematology, Guangzhou, Guangdong 510630, P.R. China.

Department of General Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, P.R. China.

出版信息

Oncol Lett. 2020 Nov;20(5):266. doi: 10.3892/ol.2020.12129. Epub 2020 Sep 21.

Abstract

Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors, and has high incidence and mortality rates, worldwide. Myelodysplastic syndrome (MDS), a disorder of hematopoietic stem or progenitor cells, results in marrow failure, which increases the risk of acute myeloid leukemia (AML). Few studies had reported patients who have suffered from both ESCC and MDS/AML simultaneously. To identify possible potential associations between ESCC and MDS/AML, the present case report describes a patient with both types of these tumors at the same time. Following endoscopic biopsy, the patient was revealed to have moderately differentiated SCC. MDS with excess blasts was subsequently diagnosed following bone marrow aspiration. The results of next-generation sequencing revealed that TP53 and ROS1 were both found in ESCC and MDS/AML tumors. The patient refused therapeutic intervention and died within 20 days. The current report demonstrated that hematologic malignancies presenting alongside solid tumors should be considered clinically. In addition, the report indicated that bone marrow puncture should be performed in patients with solid tumors and abnormal blood test results. Next-generation sequencing may be a useful technique for the investigation of patients with two or more neoplasms. However, more research regarding the co-existence of solid tumors with hematological malignancy are required.

摘要

食管鳞状细胞癌(ESCC)是最常见的恶性肿瘤之一,在全球范围内具有较高的发病率和死亡率。骨髓增生异常综合征(MDS)是一种造血干细胞或祖细胞疾病,可导致骨髓衰竭,增加急性髓系白血病(AML)的风险。很少有研究报道过同时患有ESCC和MDS/AML的患者。为了确定ESCC与MDS/AML之间可能存在的潜在关联,本病例报告描述了一名同时患有这两种肿瘤的患者。经内镜活检,该患者被诊断为中度分化鳞状细胞癌。随后经骨髓穿刺诊断为伴有过多原始细胞的MDS。二代测序结果显示,TP53和ROS1在ESCC和MDS/AML肿瘤中均有发现。该患者拒绝治疗干预,20天内死亡。本报告表明,临床上应考虑实体瘤伴发血液系统恶性肿瘤的情况。此外,报告指出,对于实体瘤患者且血液检查结果异常者,应进行骨髓穿刺。二代测序可能是用于研究患有两种或更多种肿瘤患者的有用技术。然而,关于实体瘤与血液系统恶性肿瘤共存还需要更多的研究。

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