肺肠型腺癌5例临床病理及预后分析  

Pulmonary enteric adenocarcinoma:a clinicopathological and prognostic analysis of 5 cases

作　　者：李青[1] 刘志峰 穆玉玲[1] 董娜娜 董成功 付爱芹 Li Qing;Liu Zhifeng;Mu Yuling;Dong Na′na;Dong Chenggong;Fu Aiqin(First Department of Oncology,Yantaishan Hospital Affiliated to Binzhou Medical University,Yantai 264025,China;Department of Pathology,Yantaishan Hospital Affiliated to Binzhou Medical University,Yantai 264003,China)

机构地区：[1]滨州医学院附属烟台山医院肿瘤内一科,烟台264025 [2]滨州医学院附属烟台山医院病理科,烟台264003

出　　处：《中华转移性肿瘤杂志》2024年第6期593-597,共5页Chinese Journal of Metastatic Cancer

基　　金：烟台市科技计划项目(2021YT06000783);山东省医药卫生科技发展计划项目(202003100409)。

摘　　要：目的探讨肺肠型腺癌(PEAC)的临床病理特点、治疗及预后。方法收集2011年8月至2024年3月烟台市烟台山医院收治的5例PEAC患者的临床病理资料,分析其临床病理特点、诊疗及预后,并复习相关文献。结果5例PEAC患者的平均发病年龄53.6岁,伴肿瘤标志物癌胚抗原、糖类抗原19-9、糖类抗原15-3的升高;3例患者EGFR无突变、PD-L1检测阴性或<1%,1例患者合并KRAS G12D位点突变。患者影像学表现无特异性,以周围型肺癌多见。组织学改变:镜下肿瘤细胞呈高柱状,假复层排列。5例PEAC患者可见CDX2、CK20、Villin、CK7、TTF-1和NapsinA的表达。4例手术患者预后较好,至今仍存活;1例初诊骨转移患者,预后较差,总生存期为12个月。结论PEAC临床罕见,易与转移性结直肠癌及典型原发性肺腺癌混淆。肺肠型腺癌的治疗多参考肺腺癌,尚无标准治疗方案。早期患者预后较好,晚期患者在各线治疗方案中获益较少。Objective To investigate the clinicopathological features,treatment and prognosis of pulmonary enteric adenocarcinoma(PEAC).Methods Clinicopathological data were collected from 5 patients with PEAC admitted to Yantaishan Hospital from August 2011 to March 2024.The clinicopathological features,diagnosis,treatment and prognosis were analyzed,and the relevant literature was reviewed.Results The 5 patients with PEAC were aged 53.6 years on average,with increased levels of the tumor markers CEA,CA19-9 and CA15-3.EGFR gene was not mutated and PD-L1 was negative or<1%in 3 cases,and KRAS G12D mutation was detected in 1 case.The imaging findings were non-specific,and peripheral lung cancer was the most common.Histological changes were as follows:microscopic tumor cells showed a high columnar shape,and pseudostratified arrangement.CDX2,CK20,Villin,CK7,TTF-1 and NapsinA were expressed in 5 PEAC patients.4 cases had good prognosis and were still alive.One patient with bone metastasis at initial diagnosis had a poor prognosis with an overall survival time of 12 months.Conclusions Pulmonary enteric adenocarcinoma is rare in clinic and is easily confused with metastatic colorectal cancer and typical primary pulmonary adenocarcinoma.The treatment of PEAC mainly refers to lung adenocarcinoma,and there is no standard treatment at present.Early-stage patients have a better prognosis,while late-stage patients benefit less from various treatment options.

关 键 词：肺肠型腺癌 免疫组织化学 分子特征 治疗及预后 

分 类 号：R73[医药卫生—肿瘤]