Ye Minhua, Ren Sijia, Wang Chunguo, Shi Xiaoshun, Shen Jianfei
Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Wenzhou, 317000, People's Republic of China.
Department of Cardiothoracic Surgery, Taizhou Hospital of Zhejiang Province Affiliated to Zhejiang University School of Medicine, Hangzhou, 310000, People's Republic of China.
Cancer Manag Res. 2021 Feb 25;13:1981-1987. doi: 10.2147/CMAR.S292789. eCollection 2021.
Primary adenoid cystic carcinoma (ACC) of the lung, which arises from the bronchial gland and is rare, accounting for only 0.04-0.2% of all primary lung tumors. The genetic profiling of bilateral ACC of unknown primary site and application in postoperative decision-making are less reported.
A 57-year-old male with a smoking history of over 30 years and multiple nodules in both lungs was present to our department. After assessing the bilateral solid nodules in his Positron Emission Tomography-Computed Tomography (PET/CT) scan, malignant lesions at the left lower lung, right lower lung, and right middle lung are suspected. Sequential selective video-assisted thoracoscopic surgeries (VATS) were performed. A genetic alteration test of 425 cancer-related genes and global gene expression profile of the specimens revealed intrapulmonary metastasis existed. The patient was followed up for three years without recurrence and tissue mutations in liquid biopsy.
We present a way of omics-based multiple pulmonary lesions origin assessment, facilitating post-operative differential diagnosis and treatment decision for difficult cases.
原发性肺腺样囊性癌（ACC）起源于支气管腺体，较为罕见，仅占所有原发性肺肿瘤的0.04 - 0.2%。关于原发部位不明的双侧ACC的基因谱分析及其在术后决策中的应用报道较少。
一名有30多年吸烟史的57岁男性因双肺多发结节前来我院就诊。在评估其正电子发射断层扫描 - 计算机断层扫描（PET/CT）中的双侧实性结节后，怀疑左下肺、右下肺及右中肺存在恶性病变。遂依次进行了选择性电视辅助胸腔镜手术（VATS）。对标本进行的425个癌症相关基因的基因改变检测及全基因表达谱分析显示存在肺内转移。该患者随访三年无复发，液体活检未发现组织突变。
我们提出了一种基于组学的多肺病变起源评估方法，有助于疑难病例的术后鉴别诊断和治疗决策。
