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原发性肺 NUT 癌及通过二代测序鉴定出的一些罕见体细胞突变:一例报告

The primary pulmonary NUT carcinomas and some uncommon somatic mutations identified by next-generation sequencing: a case report.

作者信息

Liu Ying, Li Yan-Ying, Ke Xue-Xuan, Lu You

机构信息

Department of Thoracic Oncology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.

Department of Pathology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

AME Case Rep. 2020 Oct 30;4:24. doi: 10.21037/acr-19-168. eCollection 2020.

Abstract

Nuclear protein in testis (NUT) carcinoma (NUT-C) is an exceedingly rare and aggressive squamous tumor characterized by an acquired rearrangement of the NUT gene involving the NUTM1 (Nut midline carcinoma, family member 1, NUT) gene encoding the nuclear protein of the testis on 15q14. As a rare tumor, there is little information available on the clinicopathologic and molecular cytogenetic findings of NMC. We herein reported a case of a 69-year-old man diagnosed with lung NMC involving the rearrangement of chromosomal region 15q14 harboring the NUTM1 gene. It was exceptionally rare for the patient's involving of the lung but having the chance to be totally resected. After radical surgery, the patient accepted further four cycles of chemotherapy and remains disease-free after 10 months. The immunohistochemical staining of PDL1 was negative and next-generation sequencing technology identified genomic alterations in discoidin domain receptor tyrosine kinase 2 (DDR2), cyclin D1 (CCND1), B-cell leukemia/lymphoma 1 (BCL1), colony-stimulating factor 1 receptor (CSF1R), runt related transcription factor 1 (RUNX1) and death domain-associated protein 6 (DAXX6) from the paraffin-embedded tissue. This case will contribute to not only a better understanding of the molecular mechanism of the primary pulmonary NUT carcinomas but also the potential therapeutic option for the patient.

摘要

睾丸核蛋白(NUT)癌(NUT-C)是一种极其罕见且侵袭性强的鳞状肿瘤,其特征是NUT基因发生获得性重排,涉及位于15q14的编码睾丸核蛋白的NUTM1(Nut中线癌,家族成员1,NUT)基因。作为一种罕见肿瘤,关于NMC的临床病理和分子细胞遗传学发现的信息很少。我们在此报告一例69岁男性患者,诊断为肺NMC,涉及携带NUTM1基因的15q14染色体区域重排。该患者累及肺部但有机会进行根治性切除极为罕见。根治性手术后,患者接受了四个周期的化疗,10个月后仍无疾病进展。PDL1免疫组化染色为阴性,二代测序技术在石蜡包埋组织中鉴定出盘状结构域受体酪氨酸激酶2(DDR2)、细胞周期蛋白D1(CCND1)、B细胞淋巴瘤/白血病1(BCL1)、集落刺激因子1受体(CSF1R)、 runt相关转录因子1(RUNX1)和死亡结构域相关蛋白6(DAXX6)的基因组改变。该病例不仅有助于更好地理解原发性肺NUT癌的分子机制,也有助于为患者提供潜在的治疗选择。

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