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肺肉瘤样癌合并肺结核:一例报告及文献复习

Pulmonary sarcomatoid carcinoma coexisting with tuberculosis: a case report and literature review.

作者信息

Huang Zhi-Hao, Zhu Yu-Fei, Zeng Yun-Yun, Huang Hui-Yi, Liu Jia-Qi, Cen Wen-Chang, Su Shan

机构信息

Department of Oncology, Guangzhou Chest Hospital, Guangzhou, China.

Graduate School, Guangzhou Medical University, Guangzhou, Guangdong, China.

出版信息

Front Oncol. 2025 Jan 10;14:1492574. doi: 10.3389/fonc.2024.1492574. eCollection 2024.

Abstract

Pulmonary sarcomatoid carcinoma (PSC) is a rare non-small-cell lung cancer with sarcomatous components or sarcomatoid differentiation, high degree of malignancy, and insensitivity to chemotherapy or radiotherapy. The management of PSC coexisting with tuberculosis (TB) poses a greater challenge, as it necessitates concurrent administration of both anti-TB and anti-neoplastic therapies. The efficacy of anti-PD-1 immunotherapy in non-small-cell lung cancer is promising, but its safety in patients with co-existent TB remains uncertain. Here, we describe a case of advanced PSC coexisting with TB, which experienced progression-free survival (PFS) of over 36 months after receiving anti-TB and anti-neoplastic therapy composed of chemotherapy, vascular targeting therapy, and PD-1 inhibitors simultaneously. The patient is still being followed up with a satisfactory quality of life. This paper is focused on the characteristics and treatment of PSC and discuss the clinical strategies of lung cancer coexisting with TB.

摘要

肺肉瘤样癌(PSC)是一种罕见的非小细胞肺癌,具有肉瘤成分或肉瘤样分化,恶性程度高,对化疗或放疗不敏感。PSC合并肺结核(TB)的治疗带来了更大的挑战,因为需要同时给予抗结核和抗肿瘤治疗。抗PD-1免疫疗法在非小细胞肺癌中的疗效很有前景,但其在合并TB患者中的安全性仍不确定。在此,我们描述了一例晚期PSC合并TB的病例,该患者在同时接受由化疗、血管靶向治疗和PD-1抑制剂组成的抗结核和抗肿瘤治疗后,无进展生存期(PFS)超过36个月。患者仍在接受随访,生活质量令人满意。本文重点关注PSC的特点和治疗,并讨论肺癌合并TB的临床策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47aa/11757094/ad8193294a42/fonc-14-1492574-g001.jpg

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