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病例报告:胆囊混合性神经内分泌-非神经内分泌肿瘤患者的免疫治疗反应

Case Report: Response With Immunotherapy in a Patient With Mixed Neuroendocrine Non-Neuroendocrine Neoplasms of the Gallbladder.

作者信息

Liu Chao, Hua Xiangwei, Yang Zhen, Guo Yuan, Wu Liqun, Cai Jinzhen, Li Ling, Zhang Yaxuan, Fan Ning

机构信息

Liver Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, China.

Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

Front Oncol. 2021 Nov 18;11:770156. doi: 10.3389/fonc.2021.770156. eCollection 2021.

Abstract

BACKGROUND

Primary neuroendocrine tumors of the gallbladder (GB-NETs) are rare, accounting for 2% of all gallbladder cancers. Among GB-NETs, mixed neuroendocrine non-neuroendocrine neoplasms of the gallbladder (GB-MiNENs) are sporadic.

CASE PRESENTATION

A 56-year-old woman admitted to our hospital due to right upper abdominal pain of 3 days duration. She underwent positron emission tomography/computed tomography, which showed multiple metastatic tumors and was unsuitable for operation. Initially, the patient was diagnosed with gallbladder adenocarcinoma. She underwent PD-1 inhibitor or combined with chemotherapy considering the PD-L1 high positive score. In the latter, the patient has the opportunity of surgery, and the new diagnosis was MiNENs. She achieved long-term disease control and has been alive from the first diagnosis.

CONCLUSION

This case might support the strategy that PD-1 inhibitor could provide a feasible treatment option for MiNENs of gallbladder patients with the positive expression of PD-L1 in the future.

摘要

背景

原发性胆囊神经内分泌肿瘤(GB-NETs)较为罕见,占所有胆囊癌的2%。在GB-NETs中,胆囊混合性神经内分泌-非神经内分泌肿瘤(GB-MiNENs)为散发性。

病例介绍

一名56岁女性因持续3天的右上腹疼痛入院。她接受了正电子发射断层扫描/计算机断层扫描,结果显示有多处转移性肿瘤,不适合手术。最初,该患者被诊断为胆囊腺癌。考虑到程序性死亡受体1(PD-1)配体1(PD-L1)高阳性评分,她接受了PD-1抑制剂治疗或联合化疗。在后者治疗中,患者获得了手术机会,新诊断为MiNENs。她实现了疾病的长期控制,自首次诊断以来一直存活。

结论

该病例可能支持这样一种策略,即未来PD-1抑制剂可为PD-L1阳性表达的胆囊MiNENs患者提供一种可行的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a3d/8637330/033e4a111691/fonc-11-770156-g001.jpg

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