病例报告:一名进行了基因分析的患者发生食管、胃和结肠三重原发性恶性肿瘤

Case Report: Triple Primary Malignant Tumors of the Esophagus, Stomach, and Colon in a Patient With Genetic Analysis.

作者信息

Zhan Xiaoli, He Lingzhe, Song Kai, Cao Shuliang, Meng Erhong, Wang Yuedong

机构信息

Department of General Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.

Department of Pathology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Genet. 2021 Jul 9;12:676497. doi: 10.3389/fgene.2021.676497. eCollection 2021.

Abstract

The incidence of multiple primary malignant tumors (MPMTs) has increased greatly with the progress of tumor diagnosis and therapy technology. However, triple primary cancer is still very rare, and its genetic change is not clear yet. This case report described a 70-year-old Chinese male patient with triple primary cancers of the esophagus, stomach and right-sided colon. Pathological examination confirmed that each malignant tumor developed independently. Next-generation sequencing (NGS) using a 599-gene panel revealed five mutations in three tumor tissues. These variations might contribute to development of the triple primary malignant tumors in the patient. The patient underwent laparoscopic feeding jejunostomy and postoperative radiotherapy for synchronous esophageal and gastric carcinomas. Then, he underwent laparoscopic-assisted resection of right-sided colonic cancer and lysis of abdominal adhesions. By the time of submitting this manuscript, the patient had been well and no sign of recurrence or metastasis had been observed. To the best of our knowledge, this case is the first one to clarify the genetic abnormalities of triple primary cancers of esophagus, stomach and colon in a Chinese patient. It may contribute to understanding the molecular pathogenesis of multiple primary digestive malignancies and providing valuable treatment strategies for the similar patients in the future.

摘要

随着肿瘤诊断和治疗技术的进步,多原发性恶性肿瘤(MPMTs)的发病率大幅上升。然而,三原发性癌仍然非常罕见,其基因变化尚不清楚。本病例报告描述了一名70岁的中国男性患者,患有食管、胃和右侧结肠癌的三原发性癌。病理检查证实每个恶性肿瘤均独立发生。使用599基因panel的二代测序(NGS)在三个肿瘤组织中发现了五个突变。这些变异可能促成了该患者三原发性恶性肿瘤的发生。该患者因同步性食管癌和胃癌接受了腹腔镜空肠造口术及术后放疗。随后,他接受了腹腔镜辅助右侧结肠癌切除术及腹部粘连松解术。在提交本稿件时,患者情况良好,未观察到复发或转移迹象。据我们所知,本病例是首例明确中国患者食管、胃和结肠三原发性癌基因异常的病例。它可能有助于理解多原发性消化系恶性肿瘤的分子发病机制,并为未来类似患者提供有价值的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1e5/8299121/600b92ba0eb0/fgene-12-676497-g0001.jpg

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