同时性多原发肺癌的临床诊治
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国家自然科学基金面上项目(81472486)


Clinical diagnosis and treatment of synchronous multiple primary lung cancer
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    摘要:

    目的 探讨同时性多原发肺癌(SMPLC)的临床诊治思路及二代测序(NGS)技术的诊断价值。方法 对1例最初被确诊为“左肺下叶腺癌伴左侧胸膜、双肺内、胸椎转移EGFR(+)”一线使用吉非替尼后原发病灶及转移病灶出现不同反应的患者,经穿刺活检及NGS检测被确诊为同时性双原发肺癌,给予二线吉非替尼联合克唑替尼治疗,并追踪随访。结果 随访1个月后右肺病灶明显缩小,病情稳定。结论 多原发肺癌(MPLC)与肺内转移癌的鉴别影响着治疗和预后,影像学及病理学诊断有时仍难以区分,NGS能高通量检测基因序列信息,具有较高的经济效益比,对MPLC的个体化精准治疗具有重要意义。

    Abstract:

    Objective To investigate the clinical diagnosis and treatment of synchronous multiple primary lung cancer(SMPLC)and diagnostic value of nextgeneration sequencing( NGS ). Methods A case was initially diagnosed as “Left lung adenocarcinoma with EGFR mutation and with metastasis to the left pleura, both lungs, thoracic vertebrae”showed different therapeutic responses between primary and metastatic cancer underwent the firstline therapy with gefitinib. After puncture biopsy and NGS. It was diagnosed as simultaneous double primary lung cancer, and then given the second line therapy with gefitinib and crizotinib. Results Followedup for one month,the right lung tumor was significantly reduced, symptoms became stable. Conclusion The identification of multiple primary lung cancer (MPLC) and lung metastatic carcinoma affects the treatment and prognosis. Imaging and pathological diagnosis are sometimes indistinguishable. NGS can detect gene sequence information with high throughput and has high economic benefit ratio, which is of great significance to the individualized accurate treatment of MPLC.

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  • 在线发布日期: 2018-07-17
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